Aetna Launches New AI and Digital Tools to Improve Access and Care

Rhea-AI Summary

Aetna, a CVS Health company (NYSE: CVS), has unveiled significant digital healthcare innovations including Aetna Care Paths and AI-driven programs. The initiative is part of CVS Health's $20 billion multi-year digital investment to simplify healthcare navigation.

The new Aetna Health app features include personalized care recommendations, vaccine scheduling, improved claims visualization, and AI-powered chat support. Notably, AI-driven clinical solutions provide nurses with 90 additional minutes daily for member interactions. The platform also introduces Smart Compare for provider recommendations and enhanced accessibility features.

Key innovations include provider availability verification through claims data, personalized cost tracking, and AI-powered bill matching for claims submission, representing a shift from transactional to journey-based healthcare management.

Positive

• Part of a substantial $20 billion multi-year digital investment by CVS Health
• AI technology provides nurses with 90 additional minutes per day for patient care
• Nearly 50% of active Aetna members use the app monthly
• Implementation of AI-driven clinical solutions enhances operational efficiency
• Introduction of personalized cost tracking and automated claims submission features

Negative

• Significant capital expenditure required for digital transformation
• Heavy reliance on technology and AI may pose cybersecurity and privacy risks

Insights

Healthcare Technology Strategist

Aetna's AI-driven tools represent a strategic competitive advantage in healthcare delivery, potentially increasing member retention and operational efficiency.

Aetna's launch of Aetna Care Paths and AI-driven programs marks a significant advancement in the healthcare insurance space. This digital transformation is part of CVS Health's $20 billion multi-year investment in technology, positioning the company at the forefront of AI-enabled healthcare delivery.

The implementation of AI-powered clinical solutions that free up 90 minutes per day for nurses represents a substantial operational efficiency gain. This translates to approximately a 20% increase in available time for direct patient care, which could drive improved health outcomes and patient satisfaction metrics.

What's particularly notable is Aetna's shift from a transactional approach to a journey-based model of healthcare delivery. This strategic pivot addresses one of healthcare's most persistent challenges: fragmentation of care. By providing personalized care paths for members with specific health conditions and consolidating relevant information in one digital location, Aetna is creating significant differentiation in the marketplace.

The high engagement rate—nearly 50% of active members using the app monthly—indicates strong user adoption. The enhanced app functionality, including vaccine scheduling, visual claim breakdowns, AI-powered chat, provider matching, and improved accessibility features, creates multiple touchpoints to strengthen member relationships and potentially reduce customer churn.

The AI-powered provider verification system that validates if doctors are truly accepting new patients solves a common friction point in healthcare navigation. Combined with personalized cost tracking and automated claims submission features, these innovations address key pain points in the member experience that typically drive dissatisfaction with health insurers.

• Aetna Care Paths, a first-to-market care option available in the Aetna Health app, makes it easier and simpler for members to get the care they need
• AI enabled clinical solutions enhance the human touch, giving nurses 90 more minutes a day to spend with members

WOONSOCKET, R.I., July 29, 2025 /PRNewswire/ -- To make the health care system easier to navigate, Aetna, a CVS Health^® company (NYSE: CVS), today announced the introduction of Aetna Care Paths and AI-driven programs as part of the company's ongoing technology investment to improve the experience for medical professionals and their patients.

Aetna Care Paths is a new digital offering available to members through the Aetna Health app. This technology simplifies the member experience by giving clarity about procedures and benefits that may be encountered and personalized care recommendations, all in one convenient location. At the core of Aetna Care Paths is a US patent-pending technology that delivers personalized recommendations for programs that will support members on their healthcare journey.

With Aetna Care Paths, members with certain health conditions receive a personalized view of their relevant benefit information as well as a care team to support them throughout their journey. Through AI-powered technology, members will find personalized health and wellness programs tailored to their specific condition, as well as the opportunities to order care kits for additional support.

Aetna Care Paths is a marked shift from the transactional approach to health care taken by most insurance companies, to one that is journey-based and holistic.

"Aetna Care Paths are one example of CVS Health's $20 billion multi-year digital investment in making health care simpler to navigate, a key aspect of Aetna's strategy of leveraging technology to deliver a better experience for our members and providers," said Nathan Frank, Senior Vice President and Chief Digital and Technology Officer at Aetna. "Leading-edge digital tools, including AI, support members at every stage of their health journey."

Nearly half of active Aetna members turn to the app each month to understand their benefits, manage their health and search for health care providers. Aetna Care Paths is just one of many tools that members can access through the Aetna App. Recent updates to the app include:

• Schedule a vaccine: Members can view, and schedule recommended vaccines through their local CVS Pharmacy and MinuteClinic within minutes. They can also find other providers of their choice.
• Better visualize claims: A new "donut" chart clearly breaks down claim costs, helping members better understand what their plan covers and what they may owe.
• Chat for quick, accurate answers: By the end of July, members will quickly find the chat icon on the home screen and core landing pages to get help when they need it. This AI-powered chat provides immediate answers and integrates seamlessly with our call centers if a higher touch is needed.
• Find the best doctor: Aetna's Smart Compare uses intelligent matching to offer members personalized provider recommendations with the highest likelihood of meeting their preferences and individual health needs.
• Advanced accessibility: A sleek, low-light dark mode interface improves accessibility and provides a more comfortable viewing experience for those who prefer a dark display – the first of its kind among leading health insurance apps.

Learn more about the Aetna Health app's capabilities.

As we help members achieve their health goals more rapidly, we also save time for our colleagues. AI-driven clinical care summaries are a unique innovation aimed at giving nurses more time – as much as 90 minutes per day, or a full day per week – to engage and support members.

"We're giving our nurses more quality time to connect with members, listen to their concerns and help them navigate their health journeys," said Dr. Ben Kornitzer, Aetna's Chief Medical Officer. "This could be a cancer patient, or a member recently diagnosed with heart disease, and that extra time in one-on-one conversations not only improves physical health outcomes but also supports our member's mental well-being. Helping our members achieve their best health, is our number one priority."

Other new Aetna technology solutions include:

• More Accurately Find Providers Accepting New Patients: Instead of only relying on information shared by providers, Aetna taps into our claims data to validate if a provider is accepting new patients.
• Personalized Cost Tracking: Offers members tools to track their in-network and out-of-network spending, monitor their deductibles, and easily access the claims associated with those costs, helping them better understand and manage their health care costs.
• Provider Bill Matching and Claims Submission: Allows members to digitally submit claims by snapping a photo of a provider bill, which AI automatically matches with existing claims, helping members understand what they may owe.

About CVS Health
CVS Health is a leading health solutions company building a world of health around every consumer, wherever they are. As of March 31, 2025, the Company had more than 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics, a leading pharmacy benefits manager with approximately 88 million plan members, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.

Media contact
David Whitrap
857-523-1219
David.Whitrap@cvshealth.com 

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SOURCE CVS Health

FAQ

What is Aetna Care Paths and how does it benefit CVS Health members?

Aetna Care Paths is a new digital offering in the Aetna Health app that provides personalized care recommendations, benefit information, and support teams for members with specific health conditions. It uses patent-pending technology to deliver customized program recommendations.

How much is CVS Health investing in digital healthcare transformation?

CVS Health is making a $20 billion multi-year digital investment to simplify healthcare navigation and improve member experience.

What new features are available in the Aetna Health app?

The app now includes vaccine scheduling, improved claims visualization, AI-powered chat support, Smart Compare for provider recommendations, and dark mode accessibility. It also offers personalized cost tracking and provider bill matching.

How does Aetna's AI technology impact nurse productivity?

Aetna's AI-driven clinical care summaries give nurses 90 additional minutes per day (equivalent to one full day per week) to spend directly supporting and engaging with members.

What percentage of Aetna members actively use the health app?

Nearly half of active Aetna members use the app monthly to understand benefits, manage their health, and search for healthcare providers.