How is CVS Health using AI to fix healthcare?

CVS Health has spent the past decade assembling one of the most far-reaching healthcare businesses in the United States. Insurance through Aetna. Pharmacy benefits through CVS Caremark. Nearly 10,000 retail pharmacies. Primary care, home health, and in-person clinics spread across the country. What has remained elusive is a consumer experience that reflects that scale.

At its investor day this week, CVS Health said it believes artificial intelligence can finally change that. The company outlined a plan to use AI and technology to create what it calls “engagement as a service,” an integrated platform designed to connect its businesses into a single, consumer-facing system.

“We are executing with discipline, strengthening our core businesses and delivering meaningful progress across our enterprise,” said President and Chief Executive Officer David Joyner. “As we look ahead, we are focused on building a simpler, more connected and more affordable healthcare experience for consumers, healthcare professionals and payors, delivering value for all stakeholders.”

Joyner, who became CEO in October 2024, inherits a strategy first articulated under his predecessor, Karen Lynch. In late 2023, CVS Health described a plan centered on a data flywheel that would use insights across its customer base to improve care delivery at multiple points. Lynch referred to the goal as providing “panoramic care.”

The leadership has changed, but CVS Health still operates at a scale few companies can match, with about 300,000 employees, 185 million consumers, and relationships with roughly 1.5 million healthcare providers. Eighty-five percent of Americans live within 10 miles of a CVS Health location.

From internal efficiency to external engagement

CVS Health is grounding its engagement strategy in work that is already underway inside the business. The company told investors it has saved more than $1 billion through internal efficiencies driven by AI and automation, money it plans to reinvest in growth and technology.

At Aetna, nurses have gained back roughly 90 minutes a day after clinical documentation was consolidated. Call center volume has fallen by 30%, and four separate care management systems have been combined into one. The insurer is also accelerating the interoperability of clinical data, a prerequisite for coordinating care across providers and settings.

Within CVS Health’s care delivery businesses, including Oak Street Health, Signify Health, and MinuteClinic, ambient AI scribe tools are now deployed in about 90% of Oak Street Health locations, reducing administrative work for clinicians and allowing more time with patients.

CVS Caremark has scaled its systems to process more than 300 claims per second during peak periods while maintaining a 99% first-call resolution rate. CVS Pharmacy continues to invest in procurement and supply chain technology to drive down costs, reinforcing its role as what the company calls the front door to healthcare. CVS Health argues that these operational gains are not isolated improvements, but the foundation for something larger: a unified engagement platform that can serve consumers across insurance, pharmacy, and care delivery.

Building one platform across many businesses

The company’s plan is to bring its businesses together through a single AI-enabled platform, anchored in one app. The aim is to reduce fragmentation by helping consumers navigate benefits, prescriptions, care services, and support in one place.

CVS Health says more than 185 million consumers interact with the company each year, and its reach spans digital channels, retail locations, and clinical settings. Executives believe that scale gives the company a rare opportunity to standardize engagement across healthcare touchpoints that are typically disconnected.

Tilak Mandadi, Executive Vice President of Ventures and Chief Experience and Technology Officer, framed the effort as essential to the future of healthcare, not an optional upgrade. “The status quo is not an option,” Mandadi said. “Healthcare can’t continue. We can’t afford it. It’s delivering bad outcomes. The experience is broken.”

Mandadi described the industry as approaching a decisive moment. “I think five years out, when we look back, we will either see a completely changed healthcare system or a completely broken-down healthcare system,” he said. “Those are the two options.”

Mandadi was clear that AI alone will not fix healthcare. “If the question is whether AI alone can change healthcare in five years, the answer is no,” he said. He argued that AI must be paired with real interoperability, structural and regulatory changes, and a willingness to redesign healthcare as AI-native rather than layering tools onto legacy systems. When those elements come together, he said, the impact could be transformative.

“AI, for the first time in a generation, is actually giving us a good shot at changing healthcare,” Mandadi said.

CVS Health has also drawn firm boundaries around how the technology will be used. Mandadi said the company established clear principles early on. AI will not be used for final clinical diagnoses. It will not be used to deny care or coverage. It will not remove the human element from care delivery.

“There’s plenty AI can do outside of those areas,” he said, pointing to reductions in administrative burden that allow pharmacists and nurses to spend more time with patients. CVS Health began working on AI long before generative tools became mainstream, he added, applying it to customer experience, operational efficiency, and access to care.

The push comes as CVS Health projects a return to stronger financial performance. The company forecast 2025 revenue of at least $400 billion, with operating income between $4.37 billion and $4.54 billion. For 2026, CVS Health expects revenue of at least $400 billion and operating income ranging from $13.26 billion to $13.60 billion, driven by margin improvements at Aetna and CVS Caremark and continued earnings at CVS Pharmacy.

CVS Health also raised its full-year outlook, now expecting adjusted earnings per share of $6.60 to $6.70, up from a prior range of $6.55 to $6.65. Revenue is expected to reach at least $400 billion, compared with a previous forecast of $397.3 billion. For fiscal 2026, the company projected adjusted EPS of $5.94 to $6.14.

“We are closing out 2025 with meaningful momentum across our businesses and we expect another year of strong earnings growth in 2026,” said Chief Financial Officer Brian Newman. Shares of CVS Health rose about 2% following the investor day presentation and have gained roughly three-quarters of their value this year, though they remain well below their highs in 2022.

For Joyner, the effort is about ensuring CVS Health’s relevance over decades.

“In my nearly 40 years at the company, I have seen our businesses and our industry find ways forward, always with consumer needs first,” he said. “Our obligation is to ensure that CVS Health is best positioned to do the most good for the most people for the next 40 years.”

CVS Health is attempting something few healthcare companies have successfully done which is to use technology and AI to unify insurance, pharmacy, and care delivery into a single experience that feels coherent to consumers. The company is no longer framing this work as experimentation. It is treating it as the next operating model for its business. Whether that model can finally make healthcare feel less fragmented will define the next chapter of one of America’s largest healthcare companies.