I recently attended the Aetna National Broker Advisory Council meeting. This event is always a very interesting opportunity for some of the most knowledgeable brokers in the country to meet with Aetna’s senior leadership team. Two-way communication is very strong, and it gives us the opportunity to provide constructive feedback on what is working in the market and what is not going well. We brokers are also a sounding board for some of the product innovations that Aetna is considering. This gives a strong sense that we are helping to shape healthcare delivery in the United States; it is a meeting I rarely miss.

Bloomberg/file photo

As I have often written, health insurance companies are taking a lead in innovation in healthcare and health insurance. Clearly, Aetna has received the message: it is about lowering the cost of healthcare. And there are a couple of notable efforts in this regard.

Aetna is aggressively moving into the provider joint venture space. Joint ventures create a stronger alignment than upside-only compensation arrangements like Patient Centered Medical Homes or ACOs (which they continue to utilize). The joint venture is a win-win situation, since providers are great at delivering care, but understanding risk is an essential skill that Aetna brings to table.

A shift in care
Aetna is also changing the way it interacts with members. The focus is shifting to a more holistic effort to change healthcare from “sick care” to “well care”, looking at physical, spiritual, and emotional wellbeing. Aetna continues to focus on modifiable health risks and has started to look at the total cost of sickness, including healthcare and productivity impact. They have done studies which point to a 2.3% – 2.4% increase in productivity for the elimination of each modifiable health risk. Consider that the average medical cost associated with a cancer incident is three times higher than a diagnosis of depression; however, the total cost of depression is twice that of cancer when factoring in productivity implications.

This approach dictates a new way of thinking about communication. More than half of the workforce is comprised of millennials and traditional communication strategies do not work. An innovative approach which was discussed is to ask employees at the time of enrollment how and when they would like to receive information from Aetna. They are doing pilots to empower call center employees to override plan rules where it makes sense, a revolutionary concept for a health insurer.

I was very encouraged by what I heard. This is the most transformational time I have seen in healthcare delivery — but transformation takes time.

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