Integrated benefits from Aetna help employers invest in workforce, lower health care costs - Denver Business Journal (2025)

Employers in Colorado are feeling the mounting pressure of rising health care costs, which are expected to grow more than 6% this year. In 2023, prescription costs alone increased by over 8% — specialty drugs and new medications like GLP-1s are likely to perpetuate this trend.

Business owners are under more pressure than ever to control workplace health care spending. As companies explore options to keep premiums affordable, some are opting for point solutions wherein one vendor delivers medical insurance, another provides prescription drug coverage, and so forth. However, this isn’t always the best approach.

That’s why Aetna®, a CVS Health® Company, is helping companies simplify, save and see better health outcomes. We offer total cost-of-care health insurance solutions with integrated medical and pharmacy benefits that are easier and more affordable for employers and employees alike.

The problem with point solutions

Carving out certain benefits may seem attractive to employers, but it doesn’t necessarily provide greater flexibility or drive savings.

It can also compound plan sponsors’ administrative burden. Points of contact across multiple vendors can quickly double or triple, requiring more coordination among business owners, benefit administration and HR professionals.

Employees feel a similar disjointedness with an “unbundled” approach. The health care system isn’t always easy to navigate, especially for people with complex or chronic conditions. And complications can grow with different outreaches to and from care managers, pharmacy benefit management contacts, claims departments and so forth.

At best, this is a detriment to the member experience. At worst, it negatively impacts a member’s care, leading to worsened health outcomes.

Total cost-of-care solutions from Aetna are poised to help

At Aetna, our integrated offerings include medical and pharmacy coverage to help solve for this fragmented experience. They are proven to deliver better outcomes at a lower cost, keeping your workforce healthier and more productive. And by leveraging the assets of our parent company, CVS Health, we can bring greater depth, breadth and innovative solutions to our customers.

Our approach allows business owners to manage their health insurance offerings through a “total cost-of-care” lens. This means that companies have a strategic view of their program, from utilization and cost trends to savings opportunities.

Integration also allows Aetna to proactively identify, outreach and engage at-risk members. This leads to improved overall clinical outcomes like higher medication adherence and lower utilization of high-cost services, such as emergency room (ER) visits, because members get the clinical support they need when they need it.

The real-world impact of integrated benefits

Combining medical and pharmacy coverage with Aetna creates positive change for our customers and their employees, including:

  1. Better financial results and greater savings. This includes an average 2% sustained lower annual medical trend. [1]
  2. More efficient health care utilization. Our model helps reduce ER visits by up to 19% and drives up to 15% lower rates of hospital admissions and readmissions. [2]
  3. Increased mental health support. Unique connections and personal outreach help drive up to a 25% increase in mental health care visits. [2]
  4. Higher medication adherence. Integrated care engine data identifies members in need of outreach related to their medication, resulting in 8% higher rates of treatment compliance. [3]
  5. Easier access to care and prescriptions. There are over 50,000 pharmacies in our network. This is in addition to the nationwide Aetna network of more than 6,300 hospitals, 275,000 primary care doctors and 550,000 specialists. [4]
  6. Innovative specialty drug programs. We offer solutions to manage specialty drug spending and lower employee out-of-pocket costs through $0 cost share specialty medications. [5]
  7. Deeply discounted retail drugs. Members receive automatically applied discounts on their medications just by presenting their Aetna ID card at the pharmacy counter.

Supporting our customers and Coloradans at large

Unsustainable health care costs impact the entire community. Local hospitals posted losses in the hundreds of millions of dollars last year and residents here continue to struggle with issues like safe housing and food insecurity that prevent them from seeking or receiving efficient health care services.

Because of this, our work at Aetna doesn’t stop with our customers. In Colorado, Aetna and CVS Health invested over $40 million towards affordable housing. We’re also proud to continue offering innovative, integrated benefits to workplaces, because employers play a critical role in giving residents access to more effective, high-value care.

Connecting all these solutions helps keep health care affordable, easy and coordinated. It’s how healthier happens together®.

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Aetna is part of the CVS Health® family of companies.

[1] Based on population of 13M members in 2020 of which ~2.16M have Rx claims; ~52% of those with Rx claims are CVS Health® fillers.

[2] Range of favorable outcomes based on Combined Medical and Pharmacy Comparative Analysis: (2019-2021). Aetna Plan sponsor Analytics. October 2022.

[3] Aetna Book of Business study.

[4] Based on physician head count for Aetna Open Access® PPO. Primary care doctors include pediatric PCPs. Specialists include Ob/Gyn and Physician Specialists. Aetna Executive Level Provider Counts (ELPC) monthly and commercial reporting sourced March 2024.

[5] Participating members enrolled in a High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA) must fully satisfy their deductible before they are eligible for a final $0 out-of-pocket cost under the program, unless the member has been prescribed a medication that qualifies as “preventive care” under the Internal Revenue Code, which is administered and enforced by the Internal Revenue Service. Members may still utilize available manufacturer copay assistance while in their deductible phase but must satisfy their deductible before the Plan is able to pick up any of the costs on the members’ behalf.

Giselle Cushing is central region vice president at Aetna, responsible for membership growth and strategy for the insurer’s commercial business across 17 states. With over 30 years of industry expertise, Cushing’s accomplishments span operations, sales, strategy and network contracting functions across all lines of business for leading health plans.
Integrated benefits from Aetna help employers invest in workforce, lower health care costs - Denver Business Journal (2025)
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