Karen Lynch

For the third consecutive year, CVS Health CEO Karen Lynch is ranked No. 1 on the Fortune Most Powerful Women list. CVS, No. 11 on the Fortune Global 500, is the largest company in the world led by a female chief executive. And the Rhode Island–based business is only getting bigger. In the past year, CVS acquired primary care provider Oak Street Health and home health care specialist Signify Health for a total of $19 billion. The deals are part of a strategy—accelerated with CVS’s 2018 acquisition of insurer Aetna—to transform the company formerly known as a drugstore chain and pharmacy benefit manager into a driving force in the health care sector. That Aetna acquisition has certainly paid off; with the deal, CVS also got Lynch, Aetna’s former president and a longtime insurance industry exec. Lynch’s decisions now affect 110 million Americans who rely on CVS Health businesses for some form of health care—not to mention her 300,000 employees. CVS touts its Oak Street and Signify deals as ways to provide better access and care to Medicare patients—a highly profitable group for the company that earned $322.5 billion in 2022 revenue. The company positions its ever-increasing size as a positive for the U.S. health care system, allowing it to meet nearly every health care need a patient might have. While other female execs run businesses that also influence society and the global economy, the sheer scale of Lynch’s mandate at CVS, the speed with which she’s executing, and its direct effects on people’s health and lives keep her at No. 1.