CVS Health is committing $20 billion over the next 10 years to overhaul the consumer healthcare experience with a more tech-enabled, integrated system. The company says the investment aims to eliminate inefficiencies and improve access in the fragmented U.S. healthcare system.
This massive initiative won’t just benefit CVS and its vertically integrated businesses—such as its pharmacy chain, Aetna insurance, and health services—it will also be open to competitors and partners across the industry. The goal is to build a more connected healthcare ecosystem.
A key focus of CVS’s vision is interoperability—ensuring all parts of the healthcare system can communicate seamlessly, ideally through a unified patient record, regardless of brand or provider. While various startups and government efforts have tried to achieve this, success has been limited.
Tilak Mandadi, CVS Health’s Chief Experience and Technology Officer, says that’s because most major players have been reluctant to disrupt themselves.
“The real agents of change are the incumbents—those with size, reach, trust, and a direct connection to consumers who are willing to disrupt themselves,” Mandadi told Yahoo Finance.
CVS, with a market cap of $80 billion and $373 billion in 2024 revenue, is one of the few companies capable of taking on such a transformation. Mandadi likens the current U.S. healthcare system to an orchestra with no conductor—everyone playing their own part with no harmony, leaving patients to manage the chaos.
The new system aims to flip the traditional healthcare experience. Rather than waiting for patients to initiate contact, CVS wants healthcare to be proactive. For instance, if a problem is detected in a pending insurance claim, the patient would be notified immediately through their preferred channel—text, call, or app—not after a denial has already occurred.
The initiative also includes building a comprehensive patient dashboard accessible to healthcare providers, pharmacies, and patients alike. This would give a broader view of an individual’s health needs beyond a single interaction or visit.
Mandadi believes this will empower patients to better understand and manage their healthcare journey.
Another major goal is simplifying insurance claims and cost estimates. While tools already exist, such as Aetna’s cost estimator, patients are still responsible for seeking out the information. CVS wants to reverse that burden.
But Mandadi emphasizes this won’t be an automation free-for-all. The company has adopted strict principles for its use of artificial intelligence:
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AI will never be used for clinical diagnoses.
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AI will not be used to deny care or claims.
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AI will not replace human interaction.
One practical application of AI already in place is voicemail analysis for pharmacy calls. If a patient leaves a message requesting delivery, AI can interpret the message and trigger the appropriate action.
On the topic of privacy and the lack of a clear legal framework, Mandadi says consumer trust will drive progress. “Consumers are willing to share data with trusted brands if it improves their experience. That’s been well established,” he said.
Still, full transformation will require collaboration from government agencies, legacy healthcare companies, and private investors to build a robust regulatory and funding structure.
The complete strategy is still evolving, but CVS believes noticeable improvements could emerge within five years, with more profound changes within a decade. “Healthcare needed an outside-in perspective on what the experience should be,” Mandadi said. “In five years, healthcare in the U.S. could look materially different. In 10 years, it could be unrecognizable—thanks to AI and technology.”
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