Aetna CEO imagines a (near) future where health insurers aren’t the middlemen

By Deanna Pogorelc 

[Image credit: @jaravis]

[Image credit: @jaravis]

October 15, 2013 1:44 pm – Aetna CEO Mark Bertolini has been just as much of a healthcare consumer as he has been a healthcare executive.

He donated a kidney to his son, who was diagnosed with T-cell lymphoma at 16, and was the equivalent of a helicopter parent to the medical team that cared for his son during his years of treatment.

So it’s not surprising that Bertolini envisions a future where the patient is at the center of everything a provider and insurer does. It is surprising, though, that he doesn’t think that world is so far away.

Healthcare reform and all of the cultural changes around it have “exposed managed care,” requiring insurers to be more transparent and patient-centric about what they do, he explained at the Cleveland Clinic Medical Innovation Summit on Tuesday. Instead of curling up in the fetal position and waiting to see how things play out, Aetna has tried to push even ahead of all of the changes in the industry.

“We take the best parts of what we do and share it with other parts of the health system to allow them to be better, and to allow us to continue to be better,” he explained.

As an example, Aetna acquired iTriage back in 2011, before mobile health exits really took off. It’s also launched a campaign called What’s Your Healthy? in an attempt to get patients to focus on managing their health, rather than getting and managing healthcare.

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If different parts of the system keep pushing for patient-centric care, and if the industry continues to push for value-based payments rather than volume-based payments, eventually insurers will be “no longer part of the game,” Bertolini said. “Our role will change, where we help connect the system, provide you with intellectual property and technology and provide you with access to capital, but we’re not in the middle,” he said to the providers in the room.

“(The current system) doesn’t work. It hasn’t worked,” he concluded. “But you have to have an economic model that’s fundamentally different from the one you have with the goal of making people healthier, economically productive and viable and happy.”


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