For years if not decades, UnitedHealth Group (UHG) and CVS Health have both pursued and exemplified the vertical integration model for healthcare. For UHG, that strategy best dates back to the launch of the unified Optum brand in 2011, while for CVS, its acquisitions of MinuteClinic in 2006, pharmacy benefit manager (PBM) Caremark in 2007, and insurer Aetna in 2018 serve as key milestones. However, an examination of UHG's and CVS's annual financial reports reveals how widely these two companies’ strategies have diverged. 
 
UHG has a bit (or a lot) of everything: it is the largest insurer, the third-largest PBM, and employs (or affiliates with) more physicians than anyone by a significant margin. Its revenue and net earnings are roughly evenly distributed between its UnitedHealthcare insurance arm and its Optum provider and PBM businesses. In contrast, CVS is largely a PBM and pharmacy services company, with a struggling insurance business and a surprisingly small care delivery arm. In 2024, Aetna posted a 0.2 percent operating margin (UnitedHealthcare had a 5.2 percent margin), and the non-pharmacy services portion of its Health Services Segment, which houses Oak Street Health and its other provider assets, generated just $11B in revenue.