Here's How to Profit on the Future of Health Care

Editor's note: Longtime Empire Financial Daily readers will remember our friend and colleague Dr. David Eifrig from our corporate affiliate Stansberry Research... "Doc" sports one of the most impressive – and eclectic – resumes in the business. After getting his MBA from Northwestern's Kellogg School, he worked on Wall Street for Goldman Sachs and Chase […] Not rendering correctly? View this e-mail as a web page [here](. [Empire Financial Daily Weekend] Editor's note: Longtime Empire Financial Daily readers will remember our friend and colleague Dr. David Eifrig from our corporate affiliate Stansberry Research... "Doc" sports one of the most impressive – and eclectic – resumes in the business. After getting his MBA from Northwestern's Kellogg School, he worked on Wall Street for Goldman Sachs and Chase Manhattan. He also earned his MD from the University of North Carolina, where he became a medical doctor and board-eligible eye surgeon. After seeing the flaws in the health care system firsthand, Doc made it his mission to empower individuals to take control of their health and wealth. And right now, [he's seeing a huge opportunity]( as the health care sector and technology take off in the years ahead... --------------------------------------------------------------- Here's How to Profit on the Future of Health Care By Dr. David Eifrig --------------------------------------------------------------- [New Vehicle Shocks EV Market]( The Wall Street Journal calls it "an American manufacturing triumph." – [Will this disrupt the entire $1.3 trillion EV boom]( --------------------------------------------------------------- Anytime you're charged $5,751 for an ice pack and a bandage... you know our health care system is broken. That's what happened to Jessica Pell. A few years ago, Pell fainted, hit her head on a table, and cut her ear. This was by no means a life-threatening injury. But any type of impact to your head can be serious. And no one wants to walk around with a cut-up ear. She went to her local emergency room – as many folks would have done. After all, she had health insurance. At the emergency room, she was given an ice pack for her head and a bandage for her ear. But the surgeon who could have stitched her ear was out of network for her insurance. That's a problem. Since the provider wasn't included in her plan, the treatment could have cost her five times as much as an in-network provider. She decided to refuse treatment. "The bill I'd probably incur would not be worth saving my ear, which was sad but a choice I had to make," Pell said in an interview with the website Vox. She later got treated by an in-network provider. During her ER visit, all she received was the ice pack and the bandage. That's it. She wasn't treated in any other way. Doctors made no diagnosis. And she made sure that no one touched her before she knew if they were in network or not. Pell received a bill for $5,751. As you can imagine, she was shocked. But it didn't stop there... Her insurance plan only picked up $862 of the bill. This was the amount it considered "reasonable and appropriate" for the services performed. So the hospital was charging Pell for the remaining $4,889. She wrote a letter to the hospital protesting the bill. Surely an ice pack and a bandage couldn't cost thousands of dollars. You could buy both items at your local drugstore for only a few bucks. A month after she sent the letter, she once again received a bill for the remaining balance. Nothing changed. It wasn't until a reporter for the Vox website began covering this story that the hospital agreed to zero out Pell's balance. Turns out, all you need for a fair bill is health insurance and a national reporter on your case. Pell's story isn't a one-time occurrence... There are countless other tales demonstrating how flawed our health care system is. Think about the last time you needed medicine or treatment... Were you afraid to go to the doctor because of fears of being overcharged? How long was your wait? Did your insurance cover most of your bill, if any? Health care has become ridiculously expensive and inefficient. And folks are more confused than ever about where they should go for various injuries and sicknesses. Then you get a bill, and you fall through the cracks. The hospital charged Pell one amount. The insurance company said no. And Pell floated around on her own with no one to appeal to. It's nearly criminal. And it can't be sustained. There is, however, one company trying to fix it... This isn't some nonprofit or government agency. It's a profitable business that works within the system right now. But it seems to realize that what's happening isn't working. And if it can succeed with some of the changes it's aiming to make... it could become the prime destination for millions of patients who want simple, affordable health care. It's poised to shape the future of our health. But before we get to the details, it's important to understand... Health care is a complex business. It has a lot of moving parts. And the U.S. health care system is easily one of the least efficient industries in the world. It comprises drugmakers, insurance companies, pharmacy benefit managers ("PBMs"), drugstores, and clinics and physician practices. Each part of the health care chain has an incentive to extract the most profit. The pharmacist needs to earn his margin, so does the drugmaker, the doctor, the hospital, the PBM, and the insurance company. And for every doctor or pharmacist you see, dozens of administrators shuffle papers, set prices, and process claims. All these levels add bloat and complexity, which mean higher costs and confused patients. We rarely see these businesses putting the customer's care first or striving to lower costs. It's an industry that needs to change... We'll start with the drugmakers. Americans spend more than anyone else in the world on prescription drugs – about $1,300 per person per year. Even though drug companies create products that save lives, they're just like every other company. Shareholders demand revenue growth and profits. Developing drugs requires a lot of capital. To get capital, you need profits. To profit on such expensive drug development, you need high prices. Meanwhile, the insurance companies make money by collecting more in premiums than they pay out in claims. The fewer claims they pay out, the higher their profits... which ultimately leads them to push costs off to customers. Then there's the PBMs. These middlemen negotiate lower prices and handle reimbursements between drugmakers and insurance companies. Former President Donald Trump has accused PBMs of "dishonest double dealing," claiming they pocket the savings from rebates and discounts instead of passing them on to consumers. Finally, there are the distributors: the drugstores, clinics, and physician practices. Incentives also play a role here. Providers of medicine are compensated based on "per service" – how many tests they run or how much medicine they sell – rather than "per successful outcome." And the more doctors and hospitals run tests and procedures, the higher the cost for insurance companies. And then, insurance companies will turn right around and charge higher premiums. It all stacks up on one another... Each layer is trying to earn its 5% or 10% profit margin. And it's the patients who suffer. --------------------------------------------------------------- Recommended Link: [Bill O'Reilly reports on 'the next great medical breakthrough of the decade']( The Gates Foundation, Fidelity, and Elon Musk are going all-in on a new development that Inc magazine says "will change health care forever." [Click here for more on O'Reilly's special report on "the next great medical breakthrough."]( --------------------------------------------------------------- In today's economy, the companies that succeed are the big ones... The race to get big is a matter of survival for a lot of these companies. Many of these markets will be winner-take-all, with one big business (or perhaps two) taking the majority market share. It's happening in the technology sector. And it's the same with media – like the competition between Disney (DIS) and Netflix (NFLX). It's the same in finance – with banks collecting bigger piles of assets to lend against. And it's happening in health care... The value of biotech and health care merger and acquisition (M&A) deals has shot up in recent years. In 2013, M&A deal values came in at $82 billion. In 2019 and 2020, they were about $300 billion each year – slowing down in 2020 only due to the economy shutdown. But the only health care company that is making real moves to fix – and dominate – the future of health care is CVS Health (CVS)... You see, in December 2017, CVS announced it would acquire health insurer Aetna for a massive $70 billion. CVS has been maneuvering toward this sort of "vertical integration" for years. Vertical integration is when two companies in different stages of production merge together. If Coca-Cola buys a bottling factory, that's a vertical merger. Coke makes the soda, and the bottler packages it. (On the other hand, if Coke bought Pepsi, it would be a horizontal merger.) Initially, there was some concern that regulators would deny the merger because of the overlap between CVS's and Aetna's Medicare Part D plans. But Aetna agreed to sell its Medicare Part D drug plan business to WellCare Health Plans to satisfy regulators. There were other critics, too, such as the American Medical Association ("AMA"). It didn't want the CVS-Aetna merger to go through – mostly because it's too beneficial for CVS. We agree. But there's no denying that the merger will ultimately help health care consumers, too. The merger won approval in late 2018, and the two companies have been operating as one ever since then. Vertical deals often produce efficiencies and benefits for consumers, such as lower prices. CVS has been making these kinds of acquisitions for years, although the Aetna merger was by far its largest. Back in 2006, CVS acquired MinuteClinic for almost $170 million. In 2007, it bought PBM Caremark Rx for more than $20 billion. CVS is now a one-stop shop for providing health care. The more parts of the health care value chain a company handles, the more it controls costs and quality of care. A merged CVS-Aetna makes a little money filling prescriptions, negotiating drug prices, providing patient care, and as an insurance provider. It can cut costs by helping patients find the best route for getting their care or by swapping in generic drugs. And it's able to earn a little extra profit by operating as a health insurer. It can also cut costs by eliminating costly administrative overhead and streamlining communication up and down the chain. That means when an employer fields bids from different health insurance companies, CVS-Aetna can offer a lower rate than insurers that must make all their profits on insurance. And when insurance companies look to hire a PBM, they'll likely get the best offer from CVS because it's just part of its business, and its size will give it greater negotiating power with drugmakers. The size here is immense... CVS is now one of the top five largest health insurers. It's also one of the largest PBMs with just under 100 million plan members. The company's retail footprint is already massive. CVS has nearly 10,000 pharmacy and drugstore locations. Many of its locations contain a CVS MinuteClinic. These sections of the store provide a nurse practitioner or physician's assistant to deliver basic tests and write some prescriptions. It may sound routine, but it's a huge opportunity for growth. On average, one trip to a MinuteClinic and you'll save 40% more than a trip to urgent care. Plus, MinuteClinics perform most of the same services as primary care facilities. They handle everything... from minor illness and injuries... to screenings and monitoring... to vaccinations and injections. The latter has made CVS an extremely essential business amid COVID-19. And perhaps the best part about CVS's business is that its stores are convenient. An estimated 85% of Americans live within four miles of a CVS pharmacy or clinic. And more than half of Americans live within 10 miles of a MinuteClinic. At the end of the day, consumers are simple... They want quality care that's easy to access and isn't overpriced. CVS provides that. And while most businesses were crushed when COVID-19 came onto the scene, CVS was actually able to benefit... For decades, people have predicted that "telehealth" or "telemedicine" would change the way we get health care. Throw together video-streaming capabilities with a scheduling app, and those tedious and expensive doctor visits could be quicker and cheaper. Even though the Journal of Telemedicine and Telecare published its first volume in 1995, the big boom never really happened... it was always just around the corner... In 2010, the New York Times said, "Although telemedicine has been around for years, it is gaining traction as never before." But how many online doctor appointments did you have over the past decade? We're guessing none... at least perhaps until the pandemic hit. While the concept makes sense, telemedicine had to overcome a lot of hurdles. The technology had to be reliable and easy to operate... doctors had to be on board... and insurance companies needed to agree to terms. And between regulations and privacy concerns, security had to be top-notch. Plus, laws had to allow doctors to prescribe drugs and treat patients without seeing them in person. But now the coronavirus outbreak has forced the shift to happen... "I think the genie's out of the bottle on this one," Seema Verma, an administrator at the Centers for Medicare and Medicaid Services, said in a Wall Street Journal piece. "I think it's fair to say that the advent of telehealth has been just completely accelerated." As of 2016, only 0.25% of Medicare recipients had used telemedicine. But Congress passed waiver authority, relaxing requirements and regulations during the pandemic that effectively gave 40 million new patients access to telemedicine. The search is on for new doctors. And the Wall Street Journal notes that appointments have doubled "as [the] pandemic reshapes health care." Telehealth services leader Teladoc Health (TDOC) increased its total visits for full-year 2021, up 38% year over year. And again, pretty much no one was utilizing telehealth before the pandemic. CVS has also been experiencing growth because of the boom in telemedicine. In 2020, former CEO Larry Merlo said telehealth and virtual visits through its MinuteClinic locations were up 600%... and home delivery of prescriptions was up a staggering 1,000%. Growth can obviously never stay at that pace, but CVS is continuing to make telehealth a bigger piece of its pie. The pandemic also drove CVS to launch E-Clinic, a new telehealth solution for its MinuteClinics. While telemedicine can be more convenient and helpful with plenty of conditions... sometimes you just need to be seen in person. And plenty of people feel more comfortable having an in-person examination. Still, some of these customer gains are "sticky"... It takes work to get people to change behavior. And the coronavirus is making everyone take those first few steps. Now that they've tried the services, a lot of customers will stick with them. Maybe they all won't... but it's still a big boost to growth. Like it or not, telemedicine is going to be a part of our future. CVS is in a great spot to capitalize. Regards, Dr. David Eifrig July 30, 2022 Editor's note: Due to the COVID-19 pandemic, innovation in the health care sector is accelerating... and that means billions of dollars in value for companies like CVS that are leading the charge. That's why Doc just launched a venture to show you how to profit from the future of health care – from telemedicine... to personalized medicine... to breakthrough drugs... to cutting-edge medical technologies. [Learn more here](. --------------------------------------------------------------- If someone forwarded you this e-mail and you would like to be added to my e-mail list to receive e-mails like this every weekday, simply [sign up here](. © 2022 Empire Financial Research. All rights reserved. Any reproduction, copying, or redistribution, in whole or in part, is prohibited without written permission from Empire Financial Research, 601 Lexington Ave., 20th Floor, New York, NY 10022 [www.empirefinancialresearch.com.]( You received this e-mail because you are subscribed to Empire Financial Daily. [Unsubscribe from all future e-mails](