Health IT, Hospitals, Policy

Aetna’s CEO outlines 4 ways it’s evolving to beat Emanuel’s prediction and survive beyond 2020

Aetna’s (NYSE: AET) CEO Mark Bertolini’s keynote at Stanford Graduate Business School’s third annual health […]

Aetna’s (NYSE: AET) CEO Mark Bertolini’s keynote at Stanford Graduate Business School’s third annual health innovation summit. was peppered with information. He broke down how the US wastes $750 billion or 30 percent of healthcare costs in needless expenses and paperwork, in between anecdotes about his son’s dramatic recovery from a rare illness thanks in part to a kidney donation from him, as well as self medicating through self- administered acupuncture. He also made a few points about how and why the 160 year old insurance company is going to defy Ezekiel Emanuel’s prediction and survive beyond 2020.

Evolution into a health IT company Even as it continues to function as a payer, the company has been acquiring and growing consumer-facing and physician facing apps programs, and platforms. He claimed that Aetna has the single best technology stack, It now has five including a private health information exchange Medicity, symptom checker and medical education tool iTriage, Active Health — a population health clinical decision and workflow management tool — and Carepass — an app platform that works as a  consumer engagement tool to connect iTriage with fitness apps like MapMyRun and FitBit, to food management apps like SparkPeople. Interestingly, Bertolini acknowledged the debate at recent House Energy and Commerce Committee hearings outlining the parameters of mobile health regulation, particularly apps, and that it would probably be working with the US Food and Drug Administration soon to sort out what would be required of the insurer.

Growing its business in China A couple of weeks ago the company agreed to set up what it says will be China’s largest private health system in Shenzhen — the city where many smartphones are manufactured and referred to as the Silicon Valley of the East. Although China opened up its markets to private insurers from other countries in 2001, it has proven to be a challenge for payers to penetrate the market. A Wall Street Journal article highlighting the market said private insurers have to devise ways to establish networks with hospitals, gain access to patient health data used by insurers to assess risk and to educate consumers. It’s establishing the health system through a joint venture agreement.

Focusing on consumer-oriented care Bertolini sees employers transitioning away from providing insurance — consumers have been paying higher deductibles and sees a shift to defined contribution plans. He also noted that the shift in costs was forcing consumers to make tough choices but suggested that they were more informed than before and would lead to behavior change. “If I am covering 80 percent of the cost of a new car, you are probably going to get a different car than if I were only covering 40 percent of the cost.” It’s also about making healthcare more convenient through technology.

Using social media to engage members  Bertolini, when asked, talked about the Twitter controversy that erupted when Arizona State University grad student Arjit Guha got into a Twitter debate with Aetna about student health plans, his diagnosis of advanced colon cancer and the problems Guha had getting his plan to cover treatment costs. After speaking with Bertolini, the insurer ended up covering all of his costs. Suffering from stage 4 colon cancer, Guha ran out of treatment options and died two weeks ago. Bertolini said he has tried to make himself available on Twitter to underscore his credibility but is also backed by some Twitter helpers and frequently deals with the kind of ethical choices this story represents and admitted he also says no to some of these requests.

[Image from wikipedia]

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