CVS Is Splitting in Two. Healthcare Still Needs to Work as One.

On November 4, CVS Health announced something that would have sounded improbable not long ago. After years spent assembling an insurer, a pharmacy benefit manager, thousands of drugstores and care businesses under one roof, the company said it intends to become two publicly traded companies. For investors, the question is whether each business will be worth more on its own. For patients, the more interesting question is whether their care can stay connected when the industry keeps changing shape.

The plan would place Aetna, CVS Caremark, CVS Specialty, Oak Street Health and Signify Health in a healthcare solutions company using the CVS Health name for now. A separate CVS Pharmacy would hold roughly 9,000 retail pharmacies, mail pharmacy, MinuteClinic and the Health100 technology services business. CVS expects the separation in the first half of 2028, subject to conditions and final approvals. It has not happened yet. CVS also says customers will continue receiving medicines, care, benefits and services without interruption.

The end of one big idea, not the end of connected care

For much of the past two decades, the industry’s answer to fragmentation was ownership. CVS combined with Caremark in 2007, acquired Aetna in 2018 and later expanded into primary care and home-based services. The premise was compelling: connect more of a person’s healthcare experience, reduce friction and make the economics work at scale. Now CVS is making a different case, arguing that distinct leadership, investment priorities and balance sheets can help each business move faster. That is a change in corporate strategy. It is not proof that coordination has become less important.

The patient still moves between organizations

Imagine a person whose cardiologist changes a prescription. An insurer determines coverage. A pharmacy fills the medication. Weeks later, a primary care clinician reviews the treatment plan. Each organization may have a valid piece of information, but those pieces answer different questions. Was the drug prescribed, approved, dispensed or stopped? Which dose is current? Who made the change, and when? A corporate parent can influence how those organizations work together. It cannot make those questions disappear.

The proposed split does not, by itself, mean that records will be lost or services disrupted. CVS has explicitly said the opposite about continuity of services. But the announcement exposes a deeper distinction: healthcare integration is not the same thing as corporate integration. A document can cross a system boundary and still arrive without the context a clinician needs. A patient can have several functioning portals and still struggle to reconstruct one accurate history. A change in ownership should not determine whether that history makes sense.