Earnings Labs

CVS Health Corporation (CVS)

Q1 2016 Earnings Call· Tue, May 3, 2016

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by. Welcome to the CVS Health Q1 Earnings Call. During the presentation all participants will be in a listen-only mode. Afterwards, we will conduct the question-and-answer session. As a reminder, the call is being recorded Tuesday, May 3, 2016. And I'd now like to turn the call over to Nancy Christal, Senior Vice President of Investor Relations. Please go ahead.

Nancy R. Christal

Management

Thank you, James. Good morning, everyone and thanks for joining us. I'm here this morning with Larry Merlo, President and CEO; and Dave Denton, Executive Vice President and CFO. John Roberts, President of CVS Caremark; and Helena Foulkes, President of CVS Pharmacy, are also with us today and will participate in the question-and-answer session following our prepared remarks. During the Q&A, please limit yourself to no more than one question with a quick follow up so we can provide more people a chance to ask their questions. Please note that we posted a slide presentation on our website before the call. It summarizes the information in our prepared remarks as well as some additional facts and figures regarding our operating performance and guidance. Later this afternoon, we'll be filing our Form 10-Q and it will also be available on our website at that time. In addition, note that during today's presentation, we'll make forward-looking statements within the meaning of the Federal Securities Laws. By their nature, all forward-looking statements involve risks and uncertainties. Actual results may differ materially from those contemplated by the forward-looking statements for a number of reasons as described in our SEC filings, including the risk factor section and cautionary statement disclosures in those filings. During this call, we'll use some non-GAAP financial measures when talking about our company's performance, including free cash flow and adjusted EPS. In accordance with SEC regulations, you can find the reconciliation of these non-GAAP items to comparable GAAP measures on the Investor Relations portion of our website. And as always, today's call is being simulcast on our website and it will be archived there following the call for one year. And now, I'll turn this over to Larry Merlo

Larry J. Merlo

Management

Well, thanks Nancy. Good morning, everyone, and thanks for joining us to hear about the solid first quarter results we posted today. Adjusted earnings per share increased 4% to $1.18, that's $0.01 above the high end of our guidance. And total company revenues increased a very healthy 19%, also above our high-end guidance number. Excluding acquisition-related integration costs and the true-up of a legal charge, operating profit increased 5% enterprise-wide, with operating profit in the Retail/Long Term Care segment in line with our expectations, and operating profit in the PBM notably exceeding expectations. We generated $1.8 billion of free cash during the quarter and continued to return significant value to our shareholders through both dividends and share repurchases. Now it's still early in the year, so we are maintaining our adjusted EPS guidance range that we provided to you at our December Analyst Day, and Dave will get into the details of our results and guidance in his remarks. So let me turn to the business update, and I'll start with the PBM selling season. Since our last update, the expected revenue impact for 2016 has grown. With gross new business at $15.2 billion, net new business of $13.1 billion, both up about $400 million from our last update. And the vast majority of this increase relates to a new health plan client, which will increase our revenues in both 2016 and 2017. We also closed out the 16th selling season with the retention rate of 97.3%. Now, turning to the 2017 selling season, it's early, but we are off to a very good start. To-date, we have completed just over a third of our client renewals, which is pretty typical for this time of year. As for new business, our integrated model continues to resonate strongly and we've already…

David M. Denton

Management

Thank you, Larry, and good morning, everyone. This morning, I will provide a detailed review of first quarter results, followed briefly with an update on our guidance. And as always, I'll start first with a summary of the various ways we continue to enhance shareholder value through our capital allocation program. Throughout the quarter, our quarterly cash dividend increased by 21% per share, and we paid approximately $470 million in dividends. Our dividend payout ratio currently stands at 31.9%, and we remain well on track to achieve our target of 35% by 2018. In addition, we have continued to repurchase our shares. In the first quarter, we repurchased approximately 22.4 million shares for $2.1 billion, or approximately $98.52 per share. So between dividends and share repurchases, we've returned approximately $2.5 billion to our shareholders in the first quarter alone. Looking forward to remainder of the year, we continue to expect to repurchase an additional $1.8 billion worth of our stock, completing the planned $4 billion in repurchases for the full year. Our expectation is that we'll return more than $5 billion to our shareholders in 2016 through a combination of both dividends and share repurchases. As Larry mentioned, we generated approximately $1.8 billion of free cash in the first quarter, and we continue to expect to produce free cash of between $5.3 billion and $5.6 billion this year. Turning to the income statement, adjusted earnings per share came in at $1.18 per share, $0.01 above the top our guidance range and 4% over LY. GAAP-diluted EPS was $1.04 per share. The Retail/Long Term Care segment delivered solid earnings within expectations, while the PBM segment posted profit growth above the high end of our guidance. The outperformance in the quarter was primarily driven by stronger-than-expected volumes and better purchasing economics within…

Larry J. Merlo

Management

Okay. Thanks, Dave. Again, I think as you heard from Dave and myself, we're off to a solid start in 2016 and our distinctive channel-agnostic solutions are resonating strongly in the market as they continue to control patient and client costs, while improving health outcomes. And we continue to believe that we have the right strategy for success in this evolving healthcare marketplace. And with that, let's go ahead and open it up for your questions.

Operator

Operator

Thank you. And our first question is from the line of Peter Costa from Wells Fargo Securities. Please proceed.

Peter Heinz Costa

Analyst · Peter Costa from Wells Fargo Securities. Please proceed

Thanks for the question, guys. I'd like to get to understand a little more about the second quarter guidance and some of the factors that you mentioned seem to mostly argue for improving dynamics over the course of the year towards the back half, but yet you showed stronger growth in Q1 relative to what you're sort of projecting for Q2. Can you help me understand what's making the pressure on Q2 or is it just some earnings move from Q2 into Q1? Help me understand what's going on there.

David M. Denton

Management

Yeah, Peter. This is Dave. I would say that our budget and our cadence of profit delivery in Q2 is essentially on plan with what we created at the beginning of the year. There's been no movement from that perspective. Again, all the factors that I cited are really first half versus second half versus first quarter versus second quarter. So again, our plan remains largely intact. Our EPS guidance for the second quarter is very consistent with our budget and our outlook as we created our plan for 2016.

Peter Heinz Costa

Analyst · Peter Costa from Wells Fargo Securities. Please proceed

Okay.

Larry J. Merlo

Management

Next question?

Operator

Operator

Our next question is from the line of Charles Rhyee from Cowen. Please proceed.

Charles Rhyee

Analyst · Charles Rhyee from Cowen. Please proceed

Yes. Thanks for taking the question. I just had a question around the Target stores and what you're seeing in terms of the traffic into the stores now that – in the ones that you've now rebranded in CVS relative to sort of what the volumes they were doing before. Have we seen a sort of a pickup there? Well, what do you see in terms of traffic around other stores, regular CVS stores outside of the Target areas?

Larry J. Merlo

Management

Well, Charles, I'll start and then I'll flip it over to Helena. But keep in mind that, as I mentioned in our prepared remarks, we're about halfway through the heavy lifting part where we're rebranding the system conversion, everything to create the look and feel of a CVS, along with all the products and services that we offer. So, as I mentioned earlier, that work won't be done until the end of summer. And I'll flip it over to Helena to pick up from there.

Helena B. Foulkes

Analyst · Charles Rhyee from Cowen. Please proceed

Yeah, I would say we're pleased so far with the performance. I would start, actually, with the fact that we have a retention rate of those Target employees of over 98%. So the first thing we know when customers come into those stores is they want to know that their Target pharmacists are still with them, and so we feel very good about that. The store conversions are going well, as Larry and Dave said, and our service scores are strong. So we're coming out of these resets feeling good about the service experience. I would say it's too soon to see any impact on script trends. We're continuing to phase in our clinical programs, and we'll see more of that in the second half of the year.

Larry J. Merlo

Management

And, Charles, keep in mind that you won't see any broad-based marketing until we've completed the integration activities. So in terms of awareness and all of those things that ultimately drive utilization, you won't see that until the fall timeframe.

Charles Rhyee

Analyst · Charles Rhyee from Cowen. Please proceed

Yeah, I just wanted to see what the early kind of signals were, and is the purchasing seamless? Like if someone just bought like a wellness product that might be still under Target? Can they still pay for it at the pharmacy desk?

Helena B. Foulkes

Analyst · Charles Rhyee from Cowen. Please proceed

Yes, absolutely.

Charles Rhyee

Analyst · Charles Rhyee from Cowen. Please proceed

Okay.

Helena B. Foulkes

Analyst · Charles Rhyee from Cowen. Please proceed

It feels very similar to what it was before. We wanted to make sure that those Target guests have a great experience, and I would say our pharmacists in those stores are still out in the aisles and talking to patients and customers and so the feedback so far has been very good.

Charles Rhyee

Analyst · Charles Rhyee from Cowen. Please proceed

Great. Thank you.

Operator

Operator

Our next question is from the line of Robert Jones from Goldman Sachs. Please proceed.

Nathan Rich

Analyst · Robert Jones from Goldman Sachs. Please proceed

Hi. This is Nathan Rich on for Bob this morning. Dave, I just wanted to go back to your comment on generic Nasonex coming a little bit earlier than expected. And it seems like there's a pretty kind of healthy calendar of new launches coming over the next several months. Just wanted to ask around the profitability of those launches; is there any reason why the profitability of the new generics that are coming this year would be any different than what we've seen in past years or maybe even a little bit better now that you guys are able to buy through Red Oak?

David M. Denton

Management

Yeah, Nathan. The profitability is, I wouldn't say better or worse, I think it's dependent upon how those products are launched. Many of those products are single-sourced generics and have an exclusivity period typically of several months. So during that exclusivity period, those products behave more like a branded product versus a break-open generic product. And again, our profits are maximized once those products break open. So if you just look at the cadence of delivery this year, a lot of those products as they come to market are in the exclusivity period.

Nathan Rich

Analyst · Robert Jones from Goldman Sachs. Please proceed

Okay. So the break-open period would probably be more kind of late this year and into 2017 for those drugs that are launching?

David M. Denton

Management

That's correct. You would see it happen late in the year, which is part of the cadence of our profit delivery, number one, and you'll see that wrapped into 2017.

Nathan Rich

Analyst · Robert Jones from Goldman Sachs. Please proceed

Okay, makes sense. And then if I could just ask one follow-up going back to your comments on the selling season. You guys highlighted an increase in RFP activity. Should we think about this kind of mainly coming from health plans, given where we are in the selling season at this point? And any color on kind of what you think is driving this kind of overall increase in RFP activity his year?

Jonathan C. Roberts

Analyst · Robert Jones from Goldman Sachs. Please proceed

Yeah, Nathan, this is Jon. So, health plans are pretty much completed. They've made their decisions and we saw similar activity the prior years. So we're in the process of working through employer and government. It's really too early to say whether overall RFP activity is going to be up or it's just the cadence and the timing. But we feel pretty good about our value prop, and as we're out with clients, our integrated model continues to resonate. And you combine that with our high levels of service, it creates a compelling value proposition. So, as Larry said, we'll give you more details in August on our Q2 earnings call.

Nathan Rich

Analyst · Robert Jones from Goldman Sachs. Please proceed

Great. Thanks so much.

Operator

Operator

Our next question is from the line of George Hill from Deutsche Bank. Please proceed.

George R. Hill

Analyst · George Hill from Deutsche Bank. Please proceed

Good morning, Larry and Dave, and thanks for taking the question. Maybe just talking about the retail pharmacy business for a second, two questions; first is, can you talk about the demand that you're seeing from the retail pharmacy side as it relates to preferred pharmacy networks and the impact on pricing? And then the second question is, post the close of the Target acquisition, have you guys seen any positive lift on reimbursement rates in the Target pharmacies now that they're owned by you guys?

Larry J. Merlo

Management

Yes, George, it's Larry. I'll start with your first question and in terms of the preferred Med D networks, George, I don't think there's anything new to reference from what we've talked about in the past. From a contracting perspective, we look at the makeup of the Med D population in terms of the, we call them the choosers versus the low-income subsidies and evaluate potential share shift against margin pressure as a determinant of our desire to participate in the preferred network. And from a consumer perspective, that carries the fact that the low-income subsidies are not subject to the co-pay differentials that you see in the chooser market and the fact that the Med D plans have a variety of options in terms of what those deltas are. So, I would say, at this point, we're not seeing anything that would surprise us from those guiding principles that I just referenced.

George R. Hill

Analyst · George Hill from Deutsche Bank. Please proceed

Larry, I'm sorry if I misspoke. I didn't mean to say Med D, I was thinking more about the commercial book and what's happening in the growth of some of the (39:56) exchange business and the Medicaid business versus Med D. I'm sorry.

David M. Denton

Management

I don't know that – George, this is Dave. I don't know if you've seen anything substantially different. The commercial business is probably hasn't adopted, I'll say, a narrow or preferred network as rapidly or as completely as Medicare has. In the Medicaid market, it's a little bit more narrow network focused and that's really where we as CVS Health from a PBM and a retail and a MinuteClinic perspective can really plugs into these Medicaid programs – managed Medicaid programs in a pretty meaningful way. And so I think it's a little bit of a sweet spot for us right now.

George R. Hill

Analyst · George Hill from Deutsche Bank. Please proceed

Okay.

Larry J. Merlo

Management

And George, on the second question, I'd just simply say that as we think about contracting, our retail pharmacy group is contracting for CVS Pharmacy in totality, which would include the Target pharmacies as well as our Long Term Care pharmacies.

George R. Hill

Analyst · George Hill from Deutsche Bank. Please proceed

Okay. Thanks for the color.

Larry J. Merlo

Management

Thanks.

Operator

Operator

Our next question is from the line of John Heinbockel from Guggenheim Securities. Please proceed.

John Heinbockel

Analyst · John Heinbockel from Guggenheim Securities. Please proceed

Hey, guys. So two things; you said the 40% of the retail margin pressure was the new business mix. I don't think the other 60% was reimbursement pressure or was that right? And just how would you characterize the reimbursement compression say versus a year ago?

David M. Denton

Management

Yeah, John, this is Dave. As I said, obviously 40% of the downdraft in the margin was related to the mix of the business which we acquired.

John Heinbockel

Analyst · John Heinbockel from Guggenheim Securities. Please proceed

Right.

David M. Denton

Management

The remainder of that is largely the effect of the reimbursement pressure within the marketplace. So that is in fact the case. You think about, we have been focused from a front store perspective on really, I'll say, tailing our promotional strategies to drive improvements in front store margin rate, and we've seen that play out at the – I guess at the detriment of probably some top-line trade off.

Larry J. Merlo

Management

And John, keep in mind as you've heard us reference that margin compression in pharmacy is – you really have two drivers behind it. You've got the mix change into some of the lower-margin businesses, principally Medicare and Medicaid. Again, very productive on top line, okay? And then you have on an apples-to-apples basis just the sheer step-down in profitability. So you've got both of those forces creating some downward pressure.

John Heinbockel

Analyst · John Heinbockel from Guggenheim Securities. Please proceed

Okay. And then secondly, different topic; when you think about creatively other ways for you to work with Target? And you're already obviously collaborating a little bit on with respect to the pharmacy, but you think about whether it be HBA, OTC, loyalty, are there any other ways creatively to – for you guys to work together, either kind of drive success in pharmacy versus HBA or is that – it really will end up being limited to pharmacy alone?

Helena B. Foulkes

Analyst · John Heinbockel from Guggenheim Securities. Please proceed

Well, this is Helena. It's something we talked a lot about with the Target folks, and essentially what we've agreed to is for right now all hands on deck and making sure that the pharmacy conversion goes really well. And as I said before, we're happy with where we are. There's a lot of work that goes into converting all of those pharmacies over and having a great experience. But we certainly think there are other opportunities for both of us when we think about, for example, loyalty, we think about different categories in the front where we have relative strength or Target has relative strength. And we haven't gone into the specifics of those because again we wanted to focus on the pharmacy, but those things could come down the road.

John Heinbockel

Analyst · John Heinbockel from Guggenheim Securities. Please proceed

Okay. Thank you.

Larry J. Merlo

Management

Thanks, John.

Operator

Operator

Our next question is from the line of Ricky Goldwasser from Morgan Stanley. Please proceed.

Ricky Goldwasser

Analyst · Ricky Goldwasser from Morgan Stanley. Please proceed

Yeah, hi. Good morning. When you talked about kind of like the top line results in the retail segment, you talked a lot about kind of like the generic comps. But was wondering what you're seeing in the marketplace in terms of branded inflation, because there's some conflicting data points in the marketplace that we are hearing. That's one. And second of all, from your seat and all this data you see both kind of like the PBM side and the retail, so you have a very unique perspective. How do you think – what do you think we'll see in terms of just kind of like the branded price increases in the environment for the remainder of the year? And maybe even into 2017 in light of the controversy and the very public debate around the gross versus net trend.

Larry J. Merlo

Management

Yeah, Ricky, it's Larry. I mean on the branded side, we're really not seeing anything out of the norm from – I mean, if you go back and look historically, this industry has seen branded inflation in the low-to-mid double digits, and so far this year, we're not seeing anything different than that. And really don't anticipate seeing anything different based on our view of the marketplace. I think what Dave was alluding to in his remarks in terms of brand mix that, again, no change in the inflation or in the assumptions that we've made around that. And we may be seeing the impact of consumer-directed health plans in terms of driving some mix changes within brand where you can say that the patient is becoming more of a payer until they reach their out of pocket max deductibles. And this is really driving patients to lower cost brand options where a generic is not available. And that's why what we see is simply an impact on revenue, but not an impact on prescription unit growth or profitability.

Ricky Goldwasser

Analyst · Ricky Goldwasser from Morgan Stanley. Please proceed

Okay. And do you expect any kind of like changes in the gross product versus rebate dynamic on more of the longer term aspect?

David M. Denton

Management

Well, Ricky, this is Dave. I do believe as you've seen over the past several years, Jon and his team in the PBM have really introduced a pretty comprehensive formulary management strategy, and with the exclusionary strategy, you've seen us improve our rebates and therefore essentially as you know the vast majority of those rebates go back to our clients in the form of a buy down in cost, and I think we will continue to innovate in that category and that process to continue to drive value for our clients.

Jonathan C. Roberts

Analyst · Ricky Goldwasser from Morgan Stanley. Please proceed

And Ricky, just to add to this, this is Jon. I mean obviously we've demonstrated we can move market share based on access when we introduced our formulary strategy back in 2012. That has created a significant amount of value. But we've also evolved this strategy to begin to negotiate price protection so that as manufacturers raise prices, a portion of that comes back to our clients in the form of a rebate. And I think some of the next things we're beginning to see is contracting by disease state. So, as an example, in the autoimmune category, we might have one rate for drugs that treat rheumatoid arthritis where you have 13 drugs that can treat that condition and a different rate for those same drugs that are prescribed for Crohn's disease where there is only four drugs in that category. So – and we see similar opportunities in oncology. So I think we're going to continue to see these negotiations and opportunities evolve, and we believe we're very innovative in this area and actually leading the industry.

Ricky Goldwasser

Analyst · Ricky Goldwasser from Morgan Stanley. Please proceed

Thank you.

Operator

Operator

Our next question is from the line of Scott Mushkin from Wolfe Research. Please proceed.

Mike D. Otway

Analyst · Scott Mushkin from Wolfe Research. Please proceed

Hey. Good morning, everyone. This is Mike Otway in for Scott. Thank you for taking the questions. I guess first question, I think mail choice was up 6.6% in the quarter, driven mostly by Maintenance Choice. Are you guys seeing some initial success with the health plan clients in adoption of the company's proprietary programs like Maintenance Choice or Pharmacy Advisor? I think, Larry, you said the new business won since the last update was a health plan. I'm just wondering what's driving that and what are you guys seeing?

Larry J. Merlo

Management

Yeah, Mike, it's Larry. I'll start and then Jon I'm sure will jump in. But if you go back and look at the new business, almost half of the new business adopted one of the Maintenance Choice programs. And I think consistent with what we've talked about in the past, we have begun to see some uptake of Maintenance Choice in the health plan segment, recognizing that that lifecycle is longer for the reasons that we've got to sell those programs through the sales organization and I think Jon's team has done a good job in terms of creating more alignment across all the stakeholders so that we have shared goals and incentives in that regard.

Jonathan C. Roberts

Analyst · Scott Mushkin from Wolfe Research. Please proceed

And then, Mike, this is Jon. So we have begun to see health plans adopt this. I would say it's still slower than what we would like to see, so we think there continues to be significant opportunity to see even more adoption and a good place for health plans to start is Maintenance Choice 2.0 that has been very successful in the marketplace. And as clients get experience with Maintenance Choice 2.0, we see them move up to the Maintenance Choice 1.0 product that moves more the volume through the Maintenance Choice channel. So we're still very bullish on this plan design.

Mike D. Otway

Analyst · Scott Mushkin from Wolfe Research. Please proceed

Okay. That's helpful. Thank you both. And I guess the next one probably for Helena. It sounds like the front end traffic is negative in the quarter and you guys pulled back on some promotions, targeted promotions. It's clearly a much smaller portion of the overall business these days, but to some extent it's how consumers see CVS. You guys have invested in Curbside, but Helena can you talk about the longer-term strategy in the front end to make sure that you guys are still continuing to stay relevant given things like online incursion and I guess ultimately what's your vision for how you want consumers to interact with the front end and with CVS?

Helena B. Foulkes

Analyst · Scott Mushkin from Wolfe Research. Please proceed

Yeah, it's a great question, something we spent a lot of time thinking about because ultimately we see the role of the front store as essentially a door into the pharmacy. This is where consumers get connected to CVS, and ultimately over time, they start using us for prescription. So it's a very important part of the business is consumers think about us. And it's why we've been shifting more and more of our focus towards health and beauty. Because when our customers think about healthcare, obviously they think pharmacy first, but they think health and beauty. And so we're in the process essentially of putting more and more effort around the health and beauty businesses and our top customers. Those have been the thrust of the two places we spent time and energy. And I'm actually quite pleased with where we are. And if you look at our health and beauty category, for example, we continue to grow share across the marketplace in health and beauty. Now, where we're pulling back are the categories Dave was speaking to earlier, it's the promotional business where it might be edibles or general merchandise, not categories we need to win in from the consumers' perspective as we think about healthcare. So I think that piece of it is sort of generally how we're thinking about the role of the front. Connected to that is the role of ExtraCare and loyalty and personalization. So we know 30% of our customers drive 80% of our sales and profit. Again, we're focused on those customers, giving them more value, more reasons to shop. And we're very happy so far. We continue to see more trips and more sales and more profit from those customer segments. And then as you said, we certainly are looking very hard at the world of digital. We know that the consumer is living in an omni-channel world and we need to be relevant. We're excited about Curbside because we thought to ourselves we don't need to out-Amazon Amazon. We certainly have an e-commerce play, but we really wanted to take advantage of 7,800 convenient locations and the fact that when the consumer needs health and beauty aid products or some milk on the way home from work or diapers, we're the convenient go-to location for her. So the fact that she can order online, let's say, from the office and pick it up on the way home and not have to get out of her car, we think is a very big winning proposition. And as Larry said, we're still in the early stages of testing that in some markets, but the research we've done with consumers is really quite encouraging.

Larry J. Merlo

Management

And just one other point to emphasize that when you drop the two acquisitions into our revenue denominator, the front now represents about 11% of our revenues. So it really affords us the opportunity to think about the front store in a very differentiated way with a different set of goals and objectives as Helena outlined.

Mike D. Otway

Analyst · Scott Mushkin from Wolfe Research. Please proceed

That's really helpful. I appreciate the time. Thank you.

Operator

Operator

Our next question is from the line of Ross Muken from Evercore ISI. Please proceed.

Ross Muken

Analyst · Ross Muken from Evercore ISI. Please proceed

Good morning, gentlemen. So, as we think about just going back to the selling season, are you seeing any change in competitiveness within certain segments whether it be health plan or government or employer or any notable trends that are different year-on-year relative to benefit design requests or interest in one service versus another or some new program you have that's maybe garnering more traction? I'm just trying to get a feel for how all of the RFP interest in sort of your recent success can kind of translate to the ultimate outcome here?

Larry J. Merlo

Management

Ross, it's Larry. I'll start and then flip it over to Jon. But I'll just share my observation from our client forum an if you go back to our Analyst Day and remember the tool that Jon demoed, our RX insights tool that can provide real-time meaningful data for clients in terms of kind of where they're at and what they can do to bend that cost curve. There was a lot more discussion around that at the client forum. And my observation was a tremendous amount of excitement and enthusiasm in terms of the ability to make that very, very actionable and to serve as a decision tool for payers in terms of the options and choices that they have.

Jonathan C. Roberts

Analyst · Ross Muken from Evercore ISI. Please proceed

Ross, this is Jon. The other thing I would add is, pharmacy is a meaningful piece of the overall healthcare cost now. So I think what's changed is the C suite is much more involved in the process than what we have seen historically. And I think what that's translated to is, very focused on cost, very focused on service, and that means that they're looking for a PBM that can implement plan designs and move their members to either new channels or new therapies, so much more of a focus on their members or their employees. And so as we're out in the marketplace, our integrated assets really position us to work with their employees or their members through all the touch points that we have to communicate and transition them to the new plan design. So this is really resonating I think to an even greater degree today than what we've seen historically. So I think from a competitive standpoint, not much change in what we've seen historically. But from a capability perspective, people are much more interested in what we can do to help them manage cost and deliver great service to their members.

Ross Muken

Analyst · Ross Muken from Evercore ISI. Please proceed

That's helpful. And just maybe quickly, can you just update us, last year you had a very successful health plan selling season. One of the big focus points is sort of converting some of those new members into the drugstore into a Maintenance Choice-like program. How does that sort of progress? What are the key sort of benchmarks we should be looking at to sort of judge how much progress you're making there?

Jonathan C. Roberts

Analyst · Ross Muken from Evercore ISI. Please proceed

Yeah, well, so if we start with employers, I mean, no surprise there. They continue to move faster to these solutions. We've seen that historically. We continue to see that. I think health plans are much more interested than what we've seen in the past, but they do continue to make decisions at a slower pace. And they have to sell to their downstream clients. So we've done a lot to work with them on educating them on the programs, as well as incentivizing their teams to sell our products and services to their downstream clients. And it's a win for them if health plans can help their clients save money. It turns into a retention tool for them if they're doing a good job on their clients' behalf and it's a win for us. As they implement plan designs, we will generally see more share. So, I think the metrics that we've shown at Analyst Day around enterprise share will continue to be how we'll measure our success in this area.

Larry J. Merlo

Management

I do think as you think forward and if you look at the contributions from generics, okay, through a payer lens, the fact that they will still contribute but the year-over-year benefit is not going to be what it's been for the last couple years. I do think it's going to very much align to what Jon was talking about in terms of people looking at some of the things that have been available, but maybe I didn't need to go there because I had another avenue to achieve my objectives. So I do think that it will be looked at differently as we go forward, and I think the point that was made earlier in terms of we've worked hard to create more alignment around goals and incentives, I think we're in a good place with that in mind.

Ross Muken

Analyst · Ross Muken from Evercore ISI. Please proceed

Makes total sense.

Larry J. Merlo

Management

Next question.

Operator

Operator

Our next question is from the line of Lisa Gill from JPMorgan. Please proceed.

Lisa Christine Gill

Analyst · Lisa Gill from JPMorgan. Please proceed

Hi. Thanks very much. I just wanted to follow up as to one of your comments, Larry, where you talked about more aggressive plan design, formulary, et cetera. Do you see incremental opportunities for mid-year plan design changes where it could actually impact the back half of this year? Or is that what you're seeing that was implemented for 01/01/2016 or is that your future thoughts on 2017?

Larry J. Merlo

Management

Well, Lisa, I'll start and flip it over to Jon. I do think, Lisa, there is the option for that to happen, largely because that design tool that I referenced earlier, it gives people real-time data. I do think that there are going to be some employer groups that are going to find that probably more challenging or difficult, especially if they have a bargaining unit, as an example. I don't think it would happen there, for obvious reasons. And I think that would break the paradigm that has existed within employers in terms of they've kind of got their cycle of when information goes out and then it gets updated on an annual basis. But there may be an opportunity to make some subtle changes along the way that I think could be meaningful.

Jonathan C. Roberts

Analyst · Lisa Gill from JPMorgan. Please proceed

So, one example, Lisa is, particularly around as it pertains to formulary, we now are rolling out programs on a quarterly basis. So in April, we rolled out a dermatological bundle that really focused on UM programs to manage the cost in this area. So, I would say that helps clients manage their cost much more effectively, and they're willing to do that throughout the year as opposed to just once a year. And we'll continue to look for opportunities not just around therapeutic categories, but even specific drugs that we think we need to take action against. I think the broader moves, network moves, as an example, will probably still happen on the cadence that we've historically seen them occur. It's a little more disruptive, and they like to do that when they're making all the other changes.

Lisa Christine Gill

Analyst · Lisa Gill from JPMorgan. Please proceed

And then I guess my second question would really be around the new Optum Walgreens Boots Alliance offering in the marketplace. Can you just comment, Jon, do you think that's going to have any impact this year's selling season, them trying to replicate or emulate something that you have at CVS? And secondly, Helena or Larry, do you see any of that impact in their ability to be able to shift scripts away from your CVS stores?

Larry J. Merlo

Management

Well, Lisa, it's Larry. I'll go ahead and start and then others may jump in. But I think, as you know, this is not the first time that a competitor has tried to create a Maintenance Choice-like program. And we've been able to effectively compete against those programs in the past. We're still the only ones with a fully integrated product, and you think about that integration, it applies both clinically as well as operationally. And Maintenance Choice is the only 90-day program that is truly channel-agnostic with the ability to realize the same enterprise economics regardless of the channel that the patient chooses. And our offering is becoming even more relevant with the addition of Target's 1,600 pharmacies into the Maintenance Choice network. And I guess just one other example of that clinical and operational integration, as you know, as we've talked about Specialty Connect, which is a more recent rollout, we've simply defined that as a Maintenance Choice product for the specialty patients. So, I think that's another proof point in terms of the real integration that exists that does provide elements of differentiation from those other programs that are attempting to mimic Maintenance Choice.

Lisa Christine Gill

Analyst · Lisa Gill from JPMorgan. Please proceed

Great. Thank you.

Larry J. Merlo

Management

Thanks, Lisa.

Operator

Operator

Our next question is from the line of Robert Willoughby from Credit Suisse. Please proceed. Robert Willoughby - Credit Suisse Securities (USA) LLC (Broker) Hi. Just one. Larry or Dave, you mentioned that the CVS retail and mail penetration of the PBM volume had been in the 40% range. It obviously comes down after the big selling season you had last year. But could you hazard a guess maybe where that stands and how quickly you could ratchet that back up to the 40% range and any longer term target you might have for that metric?

David M. Denton

Management

Yeah, hey, Bob, it's Dave. We'll update that more broadly at Analyst Day coming up in December. I will say that as Jon indicated earlier, clearly we have a lot of programs that have been adopted pretty completely within our employer book, and that continues to resonate. The opportunity we have really is in our health plan book. And not all health plans are created alike. Those health plans that are largely Medicare focused will have a different solution set and product offering that we will sell into that group of health plans that will likely not have all the mechanisms to aggressively move share compared to health plans that are more, I'll say, commercially focused that can sell in Maintenance Choice as an example. So, they will happen over different cadences. I think clearly with the adoption of and the onboarding of a bunch of new clients on 1/1, our first job was to get them onboard, get their service levels at very stable levels, and then work to sell them new programs as we cycle into 2017, so probably more to come on that, Bob. Robert Willoughby - Credit Suisse Securities (USA) LLC (Broker) And would there be a general rule of thumb I could think about, though, if you win X amount of business one year by the end of year three you'd kind of be at that range or is it just absolutely impossible?

David M. Denton

Management

I think it's impossible and the reason being is each one of those health plans, they have very different business models and they compete in very different business segments. And so again a Medicare dominated health plan, the share is going to move very slowly compared to a commercially dominated health plan. Robert Willoughby - Credit Suisse Securities (USA) LLC (Broker) Right. Okay. Thank you.

Operator

Operator

Our next question is from the line of David Larsen from Leerink. Please proceed.

David M. Larsen

Analyst · David Larsen from Leerink. Please proceed

Hey, guys. Congratulations on a good quarter. Can you talk a bit more about your indications pricing capabilities? It sounds to me like that gives you a bit of a head start with this proposed Part B rule that was recently published. And also can you talk about ScriptSync? Exactly what is that and how does that serve your client base? Thank you.

Jonathan C. Roberts

Analyst · David Larsen from Leerink. Please proceed

Yes, David, this is Jon. So we're – I talked about the autoimmune opportunity RA for – where there's more drugs that treat that disease state, so more competition, we believe we can get better rebates versus Crohn's disease. I think there are similar opportunities in oncology. So we're still early, but we're working on that. I think again there's been a lot of talk about outcomes-based contracting. We think that is a good idea, but practically very challenging. So EHRs don't communicate with each other. Members move between health plans. The information often doesn't move with them. But we believe with the tools and capabilities we have that we're best situated to make progress in this area, and we're continuing to look at it and work it then – and we'll be able to talk more about it we believe on Analyst Day.

Helena B. Foulkes

Analyst · David Larsen from Leerink. Please proceed

And then I'll pick up on ScriptSync. So this program is really as you can imagine the million people who signed up for it are basically those patients who are filling roughly four prescriptions or more per month, and as we did our research with them, what we saw and heard is their number one pain point is they've got a lot of complexity healthcare wise in their lives. The pharmacy is a piece, but there's other elements of it. So, they're making lots of trips to the pharmacy and that's hard for many of them. So a big solve for them is consolidating all of it. The way it works is we help those patients, and we line them up to one date per month, which they can come in. It sounds simple, but as you can imagine with all of the insurance plans out there, we've got to work behind the scenes to get them synced up. So that's sort of the hard part behind the solution from a consumer perspective. I think what's exciting for both the patients and the plans that we're serving is that ultimately this leads to very high consumer satisfaction and much higher levels of adherence. And that's ultimately the healthcare outcome that we were looking for as we developed ScriptSync.

David M. Larsen

Analyst · David Larsen from Leerink. Please proceed

Great. Thank you.

Operator

Operator

Our next question is from the line of Steve Halper from FBR. Please proceed.

Steve P. Halper

Analyst · Steve Halper from FBR. Please proceed

I appreciate your comments on the Target pharmacies, but one point of clarification. Would you suggest that the performance of the Target pharmacies at least on a volume perspectives are equal to where they were before the acquisition?

Jonathan C. Roberts

Analyst · Steve Halper from FBR. Please proceed

Steve, I guess you have to look at that based on timing from a seasonal perspective given year-over-year overlap with the flu. I would say we've not seen a material change in the volumes at this point in time absent that.

Steve P. Halper

Analyst · Steve Halper from FBR. Please proceed

Of course. Thank you.

Jonathan C. Roberts

Analyst · Steve Halper from FBR. Please proceed

Yep.

Larry J. Merlo

Management

Next question?

Operator

Operator

Our next question is from the line of Mohan Naidu from Oppenheimer. Please proceed.

Mohan Naidu

Analyst · Mohan Naidu from Oppenheimer. Please proceed

Thanks for taking my questions. This question maybe is for Jon or Larry. So given the focus from clients on the costs and an increasing mix of the specialty prescriptions, how are you guys seeing the change in the PBM landscape, especially with the smaller PBMs who presumably cannot impact the specialty drug cost as much as you guys can do? Is this coming up in an ongoing selling season with the clients?

Larry J. Merlo

Management

Well, Mohan, there's no question that size and scale in this business matters probably more today than it ever has, with costs in mind. And I do believe that, as we go through the RFP process, it starts with price and service, and you've got to be right there. And then we can certainly add to our offering with the differentiation that we provide in the marketplace. So, yeah, I do believe that if it is harder, if one is lacking size and scale to effectively compete.

Jonathan C. Roberts

Analyst · Mohan Naidu from Oppenheimer. Please proceed

And then, Mohan, this is Jon. So, clients' biggest concern when they think about cost they're really thinking about specialty. And about half of their specialty spend is in the pharmacy benefit, which PBMs historically have managed. And the other half of the specialty spend is under the medical benefit, which is not being managed very well today by the health plans. The platforms that they manage specialty medical on just weren't built for managed drugs. So we actually have a capability to manage that benefit across the pharmacy in medical benefit. And we think about unit cost, Larry talked about that. And so size, scale, and capabilities really make a difference there. And we're seeing specialty drugs come to market and be limited to a few providers. So our capabilities enable us to have access to those limited distribution drugs. The other side of it is, what can we do clinically to manage the 3% of our clients' patients that are driving 25% of their overall healthcare costs. And so we've integrated a capability that allows us not to just manage the specialty prescription, but to manage that patient, not just with their specialty condition, but with all their comorbidities and we've demonstrated that we can reduce overall healthcare costs. So, as we tell that story to clients, it resonates and it's a – I think it's a key decision point for them as they're making a selection in the marketplace.

Mohan Naidu

Analyst · Mohan Naidu from Oppenheimer. Please proceed

Thank you so much, Jon and Larry.

Larry J. Merlo

Management

Okay. Thank you. And we'll take one more question, please.

Operator

Operator

And our final question is from the line of Mark Wiltamuth from Jefferies. Please proceed.

Mark Gregory Wiltamuth

Analyst · Mark Wiltamuth from Jefferies. Please proceed

Thank you. So wanted to ask a little bit for, Helena, on the front-end margins, do you think there's a case to be made for more margin discipline for the industry in general? You're clearly working a margin strategy here. Walgreens is trying to enhance their margins. And I'm also just curious if right aid has been behaving any differently while we're waiting for their deal to close?

Helena B. Foulkes

Analyst · Mark Wiltamuth from Jefferies. Please proceed

Yeah, I think we're seeing a pretty rational marketplace, especially in the drugstore business. We haven't seen any major moves, I would say, the last six months or so. It may be even longer among our key drugstore competitors. And so I feel like it allows us to continue to focus on what I said before, which is driving profitable growth, focusing on that 30% of our customers where we really are seeing some nice sales and margin growth and being aware of the marketplace, but being rational as you said in terms of our approach here.

David M. Denton

Management

And, Mark, probably one thing that is a little different with CVS is just given our tenure and the depth of expertise we have from the loyalty card program, we know who our best customers are. We're engaging with them. And we design strategies that's allowed us to really tailor our market programs and our promotional offers to them. So we're probably in a different spot than some of the other industry participants at this point in time. I think we have the ability, if you will, and you saw it through this quarter to trade off a little bit of top line, but really focus our promotional dollars on those customers that really matter to drive margin expansion in the front.

Mark Gregory Wiltamuth

Analyst · Mark Wiltamuth from Jefferies. Please proceed

And Walgreens is also emphasizing cosmetics and beauty. Do you feel that at all? You mentioned your share is still gaining there. But have you noticed them changing things and has that affected your sales at all?

Helena B. Foulkes

Analyst · Mark Wiltamuth from Jefferies. Please proceed

No, I think that we continue to watch them. They're doing a nice job. But it's a big marketplace, and as I said, we're growing share in that category.

Mark Gregory Wiltamuth

Analyst · Mark Wiltamuth from Jefferies. Please proceed

Okay. Thank you.

Larry J. Merlo

Management

Okay. Everyone, thanks for your time this morning, and again, we appreciate your ongoing interest in CVS Health. And if you have any follow-up questions, you can reach out to Nancy or Mike.

Operator

Operator

Ladies and gentlemen, that does conclude the conference call for today. We thank you for your participation, and ask that you please disconnect your lines. Thank you.