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When CVS Health and Aetna announced their merger on Sunday, their executives painted an image of a dawning health care utopia. The new company, combining one of the country’s biggest pharmacies with one of its largest health insurers, will create a world where patients will get the “human touch,” they said. Fewer people will fall through the cracks, they promised, and getting high-quality, low-cost medical care will be as close as your corner drugstore. (Abelson and Thomas, 12/4)

CVS Health Corp. and Aetna Inc. are attempting to create something with little precedent: an integrated health-care enterprise that isn’t built around doctors. The combination of the two companies, in a deal valued at $69 billion and announced Sunday, is supposed to bring together Aetna’s patient data and CVS’s sprawling network of nearly 10,000 brick-and-mortar sites to squeeze out costs while improving care and convenience. (Wilde Mathews and Terlep, 12/4)

CVS Health is looking to create a national network of community medical clinics that will serve as "America's front door to quality health care." That's the goal, according to a statement by CEO Larry Merlo on his company's deal for Aetna. It's an ambitious one for CVS, a company better known as a quick stop for Tylenol and a Coke. (Kodjak, 12/4)

CVS Health Corp.’s deal to buy insurer Aetna Inc. for about $67.5 billion could be just the start of a new wave of health-care takeovers. The merger announced Sunday will leave one less independent player in the complex web of insurers, retailers and other middlemen that sit between patients and their care -- and who are under pressure to reduce costs. (Langreth, 12/4)

Next on the corporate agenda at CVS Health Corp.: lightening up the balance sheet. CVS announced new financial details from its $69 billion agreement to buy Aetna Corp. on Monday morning. Investor reaction was lukewarm: CVS sold off 3% in early trading. That reaction is understandable since CVS will see little short-term benefit from the acquisition, which is set to close in the second half of next year. (Grant, 12/4)

The proposed $69 billion merger between pharmacy giant CVS and health insurer Aetna would create a new type of health care behemoth. (Tahir and Demko, 12/4)

It’s not clear that antitrust regulators will look favorably on the $69 billion merger. Earlier this year, Aetna ended its attempt to acquire Humana, another insurance company. The deal would have created the largest private Medicare insurer in the country. Aetna had faced significant obstacles. Former Attorney General Loretta Lynch sued Aetna to prevent the deal, and it was eventually blocked by a federal court. (Weixel, 12/4)

Aetna Inc. Chief Executive Officer Mark Bertolini could walk away with at least $88.3 million if he’s terminated after CVS Health Corp. buys the insurer. Bertolini holds equity awards valued at $71.9 million at the CVS deal’s $207 offer price that would vest immediately if he’s let go within two years of a transaction, according to data compiled by Bloomberg. He’s also entitled to about $6.72 million in severance and had accumulated $9.72 million in deferred compensation and pension as of Dec. 31. (Melin, 12/4)

CVS Health Corp. shares dropped Monday as investors expressed uncertainty about the pharmacy giant’s $69-billion deal to acquire health insurer Aetna Inc. CVS stock was down 4.9% at $71.45 around 9:45 a.m. PST. Meanwhile, shares of Aetna were down 0.5% at $180.40 after an early-morning jump. (Masunaga, 12/4)

The kind of services shoppers can expect at over 800 CVS stores in Texas could become broader if the drugstore giant’s $69 billion dollar acquisition of major health insurer Aetna clears next year. On Sunday, the companies unveiled plans to create a “uniquely integrated, community-based health care experience.” That would essentially bring the drugstore chain into the health services industry and link  management of patients medical bills and prescriptions under one umbrella. (12/4)

The combination of CVS and Aetna, the Philadelphia region’s second-largest commercial insurer, would create a colossus. It would bring together a company of 9,700 stores, including 1,100 with MinuteClinics (a walk-in clinic for basic care), with an insurer that has 22.2 million customers and operations in all 50 states. CVS said 70 percent of the U.S. population lives within three miles of a CVS pharmacy. Together, the companies had $221.4 billion in revenue and $18.5 billion in operating income in the 12 months ending Sept. 30. (Brubaker, 12/5)

Through their $69 billion deal, CVS Health and Aetna are swinging an axe at the traditional ways in which patients access healthcare in hopes of building a new kind of model that's lower cost and more convenient for the consumer. At the center of this strategy is what's commonly called the new front door to healthcare: the walk-in clinic, and CVS has nearly 10,000 of them. Late Sunday, pharmacy chain and benefit manager CVS and insurer Aetna announced what would be the largest healthcare transaction to date, if approved by regulators and shareholders. The companies agreed that CVS will take over Aetna, with the No. 3 U.S. health insurer becoming a standalone unit inside the pharmacy giant. (Livingston, 12/4)

Drugstore chain CVS Health Corp. is buying Aetna Inc., one of the country’s largest health insurance companies, for $69 billion. (Ben-Achour, 12/4)

Allina Health System, one of the largest operators of hospitals and clinics in the state, said Monday it doesn’t think its plans to sell insurance coverage next year in Minnesota will be hurt by the fact that its partner in the venture, Aetna, plans to be acquired by a drugstore chain that has dozens of community clinics in the Twin Cities. (Carlson, 12/4)

Consumers might start to see some dramatic changes inside their neighborhood pharmacy. CVS Health Corp. announced that it has agreed to buy health insurance giant Aetna Inc. for $69 billion. The combined companies aim to put the retailer’s nearly 10,000 stores to better use delivering medical care that’s more convenient than what’s available from many doctors’ offices and hospitals. (12/4)

The tax overhaul Republicans are pushing toward final votes in Congress could undermine the Affordable Care Act's health insurance markets and add to the financial squeeze on Medicare over time. Lawmakers will meet this week to resolve differences between the House- and Senate-passed bills in hopes of getting a finished product to President Donald Trump's desk around Christmas. Also in play are the tax deduction for people with high medical expenses, and a tax credit for drug companies that develop treatments for serious diseases affecting relatively few patients. (Alonso-Zaldivar, 12/5)

The Republican effort to overhaul the tax code could send shudders through the health care system, potentially reshaping Obamacare while altering critical financial incentives affecting everyone from medical students to corporations and retirees with chronic illnesses. (Cancryn, 12/4)

The Senate bill’s repeal of the Obamacare mandate saves about $318 billion over 10 years but threatens to destabilize the individual markets, resulting in higher premiums and millions fewer people with health insurance. While House Republicans aren’t likely to balk at including repeal in the final bill, it could still be a problem for Sen. Susan Collins (R-ME), a pivotal vote in the upper chamber, whose support for the final package could depend on Congress’s treatment of separate measures designed to stabilize the Obamacare markets. (Rainey, 12/4)

As House and Senate lawmakers open another phase of negotiations over a $1.5 trillion federal tax overhaul, some Republicans are emboldened about pursuing new cuts to the system of health care entitlements. U.S. Sen. David Perdue said Monday that lawmakers should “absolutely” seek changes to the Medicaid and Medicare programs to help maximize the impact of the tax cuts. He echoed other Republican officials who have suggested a push for more spending cuts should be in the works. (Bluestein, 12/4)

The legislation to fund the government for two weeks could also provide some short-term relief to help states keep their Children’s Health Insurance Programs (CHIP) afloat. The bill, which would fund the government through Dec. 22, would temporarily lift certain spending constraints to allow states to get more money for CHIP from the federal government. (Weixel, 12/4)

Because Congress has yet to re-fund the Children’s Health Insurance Program, or CHIP, which funds FAMIS, the future of the program is uncertain. If federal lawmakers fail to act soon, Virginia’s program will end and 68,000 children and more than 1,000 pregnant women will lose coverage. (O'Connor, 12/4)

Sen. Susan Collins (R-Maine) has doubled the amount of money she's requesting in her ObamaCare stabilization bill in exchange for her vote on the GOP's tax-reform plan. Collins, a key vote on tax reform, is pushing for the passage of two ObamaCare bills in an attempt to mitigate the effects of the tax bill's repeal of the individual insurance mandate. (Hellmann, 12/4)

Health insurers—and hospitals—soon may be socked by a double whammy that could drive away insurers' healthier customers, induce them to spike premiums and unravel the individual market. First, the Senate Republican tax cut bill would repeal the Affordable Care Act's requirement that nearly everyone get insurance. That provision, which House Republicans support, is projected to reduce the number of insured Americans, particularly healthier people, by 13 million in 2027 and boost premiums each year by an average of 10%, according to the Congressional Budget Office. (Meyer, 12/4)

President Trump says that premiums for Obamacare are “going up, up, up.” He is partly correct and partly incorrect, according to a New York Times analysis of new data provided by the McKinsey Center for U.S. Health System Reform. (Park, 12/4)

Kaiser Health News: ‘I’ve Never Been This Busy’: As Marketplace Deadline Nears, Navigators Feel The Pinch

When Monica Spalding got the renewal letter from her health insurance company with premium details for the upcoming year, she couldn’t believe her eyes. The insurer estimated that the share of the monthly premium that she and her husband would owe for their marketplace silver plan would go up from the current $28 a month to $545. (Andrews, 12/5)

Congress last year created a task force through the National Institutes of Health to study why so few women can get reliable answers on medication use during pregnancy — and to recommend solutions. Members have been holding public meetings and reviewing the women’s comments. Experts say it’s long overdue. Few drugs have been approved as safe and effective to use during pregnancy, and most of those are for conditions specific to pregnancy. As a result, almost every medicine given to a pregnant woman, from prescription antacids for acid reflux to biologic drugs to prevent epileptic seizures, is considered an off-label use. Some doctors even take women off medications as basic and important as those that help control blood pressure, because there’s no way of knowing if they’re safe. (Thielking, 12/5)

For decades, it’s been taboo to test medications on pregnant women. But doctors, patients, and public health officials are increasingly arguing that it’s unethical not to include them in research. So new ideas for changing the research culture are emerging. Doctors, ethicists, and drug industry leaders laid out several concrete suggestions for addressing the problem in interviews with STAT and in presentations to a federal task force studying the issue. (Thielking, 12/5)

The medical homes provide the most advanced obstetrical care, but they also seek to alleviate nonmedical circumstances that could put mother and child in jeopardy, such as addiction, domestic abuse and a lack of secure housing and healthy food. North Carolina’s program is the only statewide pregnancy medical home model in the country. Among developed nations, the United States ranks last in maternal mortality and infant mortality, largely because of its high rate of untreated chronic disease and a decline in access to obstetrical care, particularly in rural areas. (Ollove, 12/5)

Pain is only the latest woe in John Bizimungu’s life. Rwandan by birth, he has lived here as a refugee since his family was slaughtered in the 1994 genocide. A cobbler, Mr. Bizimungu used to walk the streets asking people if he could fix their shoes. Now, at 75 and on crutches, he sits at home hoping customers will drop by. But at least the searing pain from the cancer that has twisted his right foot is under control. (McNeil, 12/4)

Montana has become the latest state to sue Purdue Pharma LP for its alleged role in the opioid crisis, as the pharmaceutical company presses for joint talks with states to resolve widespread accusations that its aggressive marketing contributed to addiction rates. “The epidemic began not with an outbreak, but with a business plan,” Montana Attorney General Timothy Fox said in a lawsuit filed Thursday in Lewis and Clark County state court. (Randazzo, 12/4)

Sen. Elizabeth Warren (D-Mass.) is asking for clarification on White House counselor Kellyanne Conway’s role in combating the opioid epidemic. In a letter sent Monday to John Kelly, President Trump’s chief of staff, Warren noted, in response to confusion on Conway's role last week, that “according to a report by CBS news, the White House later stated that her role was ‘not expanding and opioids has always been part of her policy portfolio,’ after multiple news outlets reported that she would be the White House's ‘drug czar.’ ” (Roubein, 12/4)

Virginia is enlisting recovering addicts in its battle against the opioid epidemic. The Richmond Times-Dispatch reported Sunday that more than 1,000 peer recovery specialists have been trained by the state’s Office of Recovery Services. They’re beginning to work in opioid treatment centers, emergency rooms and recovery centers. (12/4)

The only "Obamacare" health insurer in metro Phoenix and Pima County is ensnared in a legal dispute with several addiction treatment centers over the cost of care amid an Arizona opioid epidemic that is taking an average of two lives each day. (Alltucker, 12/4)

Opioid-driven deaths during hospital stays in the United States quadrupled between 1993 and 2014, according to a new study released Monday. (Santhanam, 12/4)

After years of debate, the organization that oversees the allocation of livers for transplant took steps Monday to address a long-standing geographic disparity in supply of the scarce organs. The policy approved by the Organ Procurement and Transplantation Network will make more livers available in some places — including cities such as New York and Chicago — where the shortage is more severe than it is in regions such as the southeastern United States. (Bernstein, 12/4)

As a practicing physician in Boston, Timothy Lu cared for very sick patients who returned repeatedly to the hospital with stubborn, serious infections that wouldn’t respond to antibiotics. He grew increasingly perplexed. “Why can’t we tackle this?” he wondered. Dr. Lu, who also holds degrees in computer science and electrical engineering, turned to the lab to develop better treatments. Yet his goal isn’t another antibiotic like the chemical compounds prescribed today. Instead “we are re-engineering the genetic code that underpins life” to help defeat superbugs, he said. (Evans, 12/5)

When it comes to persuading parents in the United States who are hesitant about vaccinating their children, the public health messages often rely on facts and science to explain how immunization not only protects those children but also shields other vulnerable people from dangerous infectious diseases. But information campaigns that emphasize fairness or preventing harm sometimes backfire and can worsen vaccine hesitancy, research has shown. A study published Monday in Nature Human Behaviour suggests a more effective way to reach vaccine-hesitant parents may be to focus on two potentially powerful moral values that underlie people’s attitudes and judgments: individual liberty and purity. (Sun, 12/4)

Does a widening waistline put you at risk for cancer? Apparently so. According to a new study, nearly 6 percent of cancers are attributable at least in part to obesity and diabetes. Researchers compared incidence data for 12 cancers in 175 countries in 2012 with body mass index and diabetes prevalence figures from 2002, on the assumption that it takes at least ten years for cancer to develop. (Bakalar, 12/4)

Mil Schooley, an 18-year-old student in Denver, Colo., says most of her friends have a JUUL — an e-cigarette that can vanish into a closed fist. When asked roughly how many, she stumbles a bit. "I wanna say like 50 or 60 percent? I don't know. Maybe it's just the people I know. All my friends in college have one," she says. "It just blew up over the summer." (Chen, 12/4)

Akili Interactive Labs on Monday reported that its late-stage study of a video game designed to treat kids with ADHD met its primary goal, a big step in the Boston company’s quest to get approval for what it hopes will be the first prescription video game. In a study of 348 children between the ages of 8 and 12 diagnosed with ADHD, those who played Akili’s action-packed game on a tablet over four weeks saw statistically significant improvements on metrics of attention and inhibitory control, compared to children who were given a different action-driven video game designed as a placebo. The company plans next year to file for approval with the Food and Drug Administration. (Robbins, 12/4)

So, you want to reduce your carbon footprint? You might consider improving your diet. It turns out that healthy eating isn't just good for your body, it can also lessen your impact on the environment. Scientists say that food production including growing crops, raising livestock, fishing and transporting all that food to our plates is responsible for 20% to 30% of total global greenhouse gas emissions. (Netburn, 12/4)

Kaiser Health News: Dangling A Carrot For Patients To Take Healthy Steps: Does It Work?

Patricia Alexander knew she needed a mammogram but just couldn’t find the time. “Every time I made an appointment, something would come up,” said Alexander, 53, who lives in Moreno Valley, Calif. Over the summer, her doctor’s office, part of Vantage Medical Group, promised her a $25 Target gift card if she got the exam. Alexander, who’s insured through Medi-Cal, California’s version of the Medicaid program for lower-income people, said that helped motivate her to make a new appointment — and keep it. (Gorman, 12/5)

Three months after Hurricane Harvey, local health officials now are beginning to see the storm after the storm. In Harris County and the other hardest-hit regions of Texas, 17 percent of those who had houses damaged or suffered income loss report that someone in their household has a new or worsening health condition. A sweeping new survey by the Kaiser Family Foundation and Houston-based Episcopal Health Foundation shows a similar proportion feels their own mental health has worsened. "We're not anywhere near the end yet," cautioned Dr. Cindy Rispin, a family physician with the Memorial Hermann Medical Group in League City. Researchers surveyed more than 1,600 Texans in 24 affected counties to gauge their personal recovery. (Deam and Sarnoff, 12/5)

The Republican-controlled Legislature could soon send Gov. Wolf a much-debated bill to roll back abortion rights in Pennsylvania. A key House committee on Monday passed the legislation, which calls for banning abortions at 20 weeks of pregnancy except in medical emergencies. Under current law, a woman cannot have an abortion after 24 weeks of pregnancy. The proposed measure would also sharply curtail a surgical procedure used in second-trimester abortions, which the bill’s supporters refer to as “dismemberment abortions,” a term not medically recognized. (Couloumbis, 12/4)

Minnesota’s health care system has driven down per-person spending on some of the most prevalent and costly chronic diseases, according to a new report designed to track the state’s progress on looming health care challenges. (Howatt, 12/4)

Baltimore health officials are urging parents with infants to practice safe sleep practices after recording a spike in sleep-related infant deaths in the city. Twelve babies have died in their sleep so far this year, compared with seven last year. The new deaths prompted City Health Commissioner Dr. Leana Wen and others to act on Monday. (McDaniels, 12/4)

Gov. Mark Dayton declared himself cancer-free on Monday while urging Minnesotans to make time to get screened for cancer if they have risk factors or family history of the disease.(Bakst, 12/4)

Advocate Health Care unveiled Monday that it plans to merge with Aurora Health Care in a deal that would create the 10th largest not-for-profit system in the country. Downers Grove, Ill.-based Advocate has turned its focus to Wisconsin's largest healthcare provider after walking away from its merger with NorthShore University HealthSystem earlier this year, which failed after a protracted antitrust review battle. The Advocate-Aurora deal would create a health system with 27 hospitals and $10.7 billion in annual revenue, the organizations said. (Kacik, 12/4)

Advocate Health Care is ready to give a merger another try — this time with Wisconsin giant Aurora Health Care, in a proposed deal that would create the 10th largest not-for-profit hospital system in the country. Under terms of the planned “50-50 merger” announced Monday, neither system would pay the other cash, and the deal could close by the middle of 2018, pending regulatory approval. A combined health system, to be called Advocate Aurora Health, would have 27 hospitals and nearly $11 billion in annual revenue. (Schencker, 12/4)

Aurora Health Care, the largest health system in Wisconsin, and Advocate Health Care Network, the largest health system in Illinois, announced an agreement on Monday to combine their operations, a merger that would create the 10th-largest nonprofit health system in the country. (Boulton, 12/4)

The Cleveland Clinic has raised more than $50 million in honor of Dr. Toby Cosgrove, who leaves his post as Clinic CEO and president at the end of the year. (Washington, 12/4)

The flu season usually peaks in late January or February, sometimes as late as March, but this year, some predictions warn that cases of flu could soar right around the winter holiday season. (Goldberg, 12/4)

A police officer from New Hampshire stepped forward to save the life of a child he’d never met. (Gallagher, 12/5)

Los Angeles County’s marquee program to provide housing for very sick homeless people saved taxpayers thousands of dollars by reducing hospitalizations and emergency room visits, a three-year Rand Corp. study released Monday found. Considered a national model, Housing for Health uses county and federal money to subsidize rents and intensive case management for acutely ill homeless people. (Holland, 12/4)

The CEOs of drug retailer CVS and health insurer Aetna were marvelously in sync Sunday when they jointly announced their companies’ $69-billion merger deal. The deal will “dramatically further empower consumers,” Aetna’s Mark Bertolini said. It will “create a platform that is easier to use and less expensive for consumers,” according to Larry J. Merlo, president and CEO of CVS Health. They repeated these mantras to the press in a series of joint interviews. All that was missing was a clue to how, exactly, this nirvana of better, cheaper healthcare was to be reached. (Michael Hiltzik, 12/4)

CVS Health says that its $69-billion takeover of insurance giant Aetna will be good for consumers. That, of course, is unlikely. For the deal to benefit consumers, it would have to result in lower drug prices or lower insurance costs. If past mergers are anything to go by, this won't happen. (David Lazarus, 12/4)

Retail thinking has its place in health care today because there are some services and products that people need quickly and which do not require a personal touch or someone who understands them as unique individuals. Such services might be low-level acute care (think strep throat), flu shots and immunizations, and some forms of simple chronic disease management, such as blood sugar checks or foot and eye exams for people with diabetes, especially if they are guideline driven. There’s no question that retail thinking can also create purchasing opportunities for things patients find useful, if not always essential, and perhaps do so in ways that are cost-effective or convenient for us. But retail health care is impersonal, lacks relational warmth, and isn’t what patients really want. (Timothy J. Hoff, 12/4)

Early Saturday morning, every Republican in the U.S. Senate — save one — endorsed a budget-busting tax cut that will do irreparable harm to the economy over the next decade. Their work isn’t done. A committee must hammer out differences between the House and Senate legislation, but that task now seems easy. Expect a tax bill to be signed before Christmas. As frustrating as that reality is, the worst may be yet to come. Cuts to Social Security, Medicare and Medicaid are likely to be next on the agenda. (12/4)

The Senate bill’s likely effects on typical health policy concerns are substantial and devastating: 13 million people could lose health insurance due to the repeal of the ACA individual mandate, and large future cuts to Medicaid and Medicare are likely in order to compensate for the ballooning deficit. But these consequences on health insurance only scratch the surface of the legislation’s potential public health impacts. By promoting the interests of the wealthy while shortchanging investments in the social factors that promote health for all of us, the House and Senate tax bills are even more damaging to our nation’s health than repealing the ACA. (Sarah E. Gollust, 12/4)

The tax bill that just passed the Senate eliminates the Affordable Care Act's individual mandate, and the House is likely to go along when Congress writes the final version. ... Our polls have consistently shown that the mandate is the least popular element of the ACA and in the abstract, more Americans (55%) would eliminate the mandate than keep it (42%). Yes, but: When people know how the mandate actually works, and are told what experts believe is likely to happen if it's eliminated, most Americans oppose repealing it in the tax plan. (Drew Altman, 12/5)

The social safety net, or welfare system, consists of a handful of programs. They include Medicaid, the Supplemental Nutrition Assistance Program (better known as food stamps), housing and disability assistance programs, Temporary Assistance for Needy Families, and several others. The programs are designed to provide stopgap assistance until households are able to get back on their feet, and in order to qualify, individuals must be close to or living in poverty. (Mark R. Rank, 12/4)

We have a dispiriting shortage of high-quality health research for many reasons, including the fact that it’s expensive, difficult and time-intensive. But one reason is more insidious: Sometimes groups seek to intimidate and threaten scientists, scaring them off promising work. By the time I wrote about the health effects of lead almost two years ago, few were questioning the science on this issue. But that has not always been the case. (Aaron E. Carroll, 12/4)

Bascom Palmer Eye Institute’s clinical professionals know that every natural disaster has a unique impact on the delivery of sight-saving vision care. After Hurricane Katrina in 2006, our physician-led team spent two weeks in Louisiana and Mississippi providing eye care to residents and first responders. Within 48 hours after the 2010 earthquake, a team from Bascom Palmer arrived in Haiti with ophthalmic equipment and supplies to offer general medical aid and eye surgery. The following year, we transported the Vision Van, our mobile eye clinic, across the Pacific to serve as a base for Japanese ophthalmologists caring for victims of the deadly earthquake and tsunami. (Eduardo C. Alfonso, 12/5)