Good morning, Broadsheet readers! There are four openly LGBTQ CEOs running Fortune 500 companies, an economist makes a comeback, and Fortune’s Maria Aspan digs into CVS CEO Karen Lynch’s role in American health care. Happy Wednesday!
– Big Health’s Big Test. Karen Lynch is the most powerful woman in business—and one of the most powerful people in health care. As CEO of CVS Health, she makes decisions that affect the health—and, ultimately, the lives—of more than 110 million people. So how is she wielding that vast power?
“I always think, sitting in this chair, ‘How would I want to be treated? How would I want my family members to be treated?’ ” Lynch told me last month, in an interview for the cover story of our new Fortune 500 issue.
“You’re not going to get it right all the time,” she acknowledges. “But how do we get better?”
For CVS—and most of its competitors—the answer has been to get relentlessly bigger, as Erika Fry and I report in our feature on the booming business of Big Health Care. CVS is No. 6 on the new Fortune 500 list, one spot below rival UnitedHealth, and their industry dominates our 2023 list of the biggest companies in business like never before. Health care companies account for eight of the top 25 U.S. companies by revenue, and with $2.77 trillion in combined revenue, the industry is now the second-largest on the Fortune 500 list, just behind finance.
CVS’s evolution beyond toothpaste and toilet paper began long before Lynch, but she’s leading an ambitious—and expensive—new pivot into primary care. She joined CVS in 2018 when it bought Aetna, the nation’s third-largest insurer, for $70 billion. Since becoming CEO in 2021, Lynch has gone hunting for more M&A, and this spring, she spent about $19 billion on two companies, primary care provider Oak Street Health and home health care specialist Signify Health. Together, these two mergers will bring more than 10,600 physicians and other medical providers under CVS’s roof.
The goal of all of this expansion, Lynch and other top health care executives say, is to fix America’s broken health care system. By owning the services to address a patient’s every need, companies say they can deliver “value-based care” more efficiently and conveniently; provide more services to lower-income patients and other underserved populations; and, ultimately, head off the chronic conditions and serious illnesses that drive up costs. Buying up businesses is about “bringing the pieces together to help drive value,” UnitedHealth chief medical officer Dr. Margaret-Mary Wilson told Erika.
But it’s a big promise—and one that faces plenty of skepticism among doctors, patients, lawmakers, and industry critics. So can Big Health care really make Americans healthier?
Lynch, for one, acknowledges the size of the task she’s taking on with CVS’s M&A spree. “My personal passion is, ‘How do we improve the health care system?’” she told me. “We have the opportunity to really drive engagement, simplicity, effectiveness—and to drive patients to the right care at the right time, in the right places.”
Read the full story here.
Maria Aspan
maria.aspan@fortune.com
@mariaaspan
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ALSO IN THE HEADLINES
- State of emergency. For the first time in its 40-year history, the Human Rights Campaign declared a state of emergency for LGBTQ+ people living in the U.S. More than 75 bills targeting the community have been signed into law this year, causing an uptick in the violence and forcing relocation, says HRC president Kelley Robinson. The NAACP recently issued a travel advisory against Florida for similar reasons. Axios
- Reconsider. Economist and academic Isabella Weber went viral in December 2021—in a bad way. Her suggestion that the government consider price controls to tamp down inflation rates while keeping employment and output high was controversial, even though the strategy was used during World War II. Nearly two years later, experts are still looking for a solution for inflation and taking hers more seriously. The New Yorker
- Out CEOs. Beth Ford of Land O’Lakes is one of four openly LGBTQ CEOs in the new 2023 Fortune 500 list. Ten years ago, there were none. That changed when Apple CEO Tim Cook came out in 2014; Ford recognizes that living authentically helps others do the same. Fortune
- Road trip radio. Jennifer Witz is the CEO of SiriusXM. The company started as two separate distribution companies using satellite radio before merging nearly 15 years ago. Now, it has branched into podcasts and is navigating the ever-changing world of car software. Witz says that focusing on delivering content to listeners helps bring all sides of the business together. The Verge
MOVERS AND SHAKERS: Teresa Asma has been promoted to COO at Solv. Pamela Harrison will be vice president and chief human resources officer at EXL. Candice Morgan and Ellie Wheeler will be joining the board at Venture Forward.
IN CASE YOU MISSED IT
- Tech play. Ceci Kurzman saw a gap in the haircare industry for tightly textured hair, so she tapped data and personalization to create OurX. The startup uses a quiz to recommend products and offers haircare consultants with a subscription. The Black hair care industry is valued at $2.51 billion. TechCrunch
- Vote of confidence. More than 93% of members of the lobby group Confederation of British Industry voted to back the organization's reform plan. The last 12 weeks have been tumultuous for the organization after the Guardian published numerous allegations of sexual harassment, prompting companies and leaders to leave the group. Guardian
- First Amendment buzzsaw. New Hampshire Public Radio journalist Lauren Chooljian wrote a story about sexual misconduct allegations against Eric Spofford, the founder of a network of addiction rehab centers. She and her family came under attack. (Spofford denies the misconduct claims and any connection to the attacks.) Spofford is now suing Chooljian and NHPR for libel, which could have consequences for freedom of the press and First Amendment protections. New York Times
ON MY RADAR
‘Congrats! You didn’t marry the wrong guy!’ 25 years of Sex and the City nailing life as a single woman Guardian
How Skims became one of the most duped brands ever The Cut
The making of Emily Bode, America’s next great fashion designer GQ
Why are the language police obsessed with vice presidents? New York Times Magazine
PARTING WORDS
“I think for me, I just felt that 40 was freedom, because I didn’t have to be the young, sweet, naive, people-pleasing ingénue anymore. I had outgrown it.”
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