Karen S. Lynch

With Karen Lynch at the helm, CVS Health claims the title of the largest Fortune 500 company led by a female CEO—with $357.8 billion in 2023 revenue—and Lynch’s influence in that role hasn’t waned. CVS Health, with its MinuteClinics and acquisition of Oak Street Health and Signify Health, is now one of the largest providers of primary care in the U.S. But the company Lynch runs has had a rough go of it this year. In August, the health care business slashed its outlook for the third straight quarter and announced a multiyear plan to cut $2 billion in costs. Its share price is down 24% since the beginning of 2024. CVS’s Aetna health-insurance unit is largely to blame; it and other insurers have been hit by rising medical costs. With everything else on her plate—including regulatory scrutiny of pharmacy benefit managers—Lynch took over direct leadership of Aetna’s day-to-day operations after its president left the insurer less than a year into the job.

(Note: On Oct. 18, after the 2024 Most Powerful Women list was published, Lynch was replaced by David Joyner as president and CEO of CVS Health.)