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New plan designs give health insurance members control, choice

Mar 31 2016

A new insurance concept called Leap from Aetna embodies two things everybody wants: simplicity and relevance. “The idea behind Aetna Leap plans came from the best practices of other consumer brands, where the buyer has more control over choice and value,” said Brian St. Hilaire, senior director of Consumer Strategy at Aetna.

In health insurance, “choice and value” translate to concrete ways an individual can manage the cost of their health care, control the way they consume it and get the care they need when they need it.  They can also get incentives like gift cards and discounts for engaging in healthy activities.

“Some people are more motivated to be in the driver’s seat of their own health,” said Adam Scott, vice president of Clinical Consumer Strategy at Aetna. “Many people with chronic conditions, like heart disease or diabetes, want to do more to self-manage and are eager for more information related to their care. One of the goals of these new plans is to remove as many barriers as possible to get members as engaged as possible, while getting the care they need and want.”

For example, Aetna offers a plan just for people with diabetes. The plan offers members access to specialists crucial to successful care such as endocrinologists, vascular specialists, podiatrists, ophthalmologists, and behavioral health specialists for the same cost as seeing a primary care physician. The plan also comes with a care management program with online resources and clinician led case management to work with customers on a day-by-day basis.

A disease-specific health insurance plan makes sense, Scott said, because it puts the emphasis on the individual’s unique health needs and challenges. “When someone has a support system that reflects their unique health priorities, that makes it easier, more convenient and more affordable for them. As a result, they are more likely to fully engage in taking better care of themselves,” Scott said.

Over 29 million people or over 9 percent of the population of the United States have diabetes, according to the Centers for Disease Control and Prevention (CDC).

Why diabetes? There’s a huge area of need with diabetes, including those who may have been given a new diagnosis or have already been dealing with the disease, Scott said. “Those with diabetes are required to make dozens of decisions throughout the course of the day, including what to eat, when to eat, how frequently to check their blood sugar, how to identify symptoms and be proactive with them, among others.”

Beyond relevance, the Aetna Leap plans emphasize convenience and access to the right kind of help.

“Most people wouldn’t associate health care with convenience,” said St. Hilaire. “When we designed this next generation of insurance plans, we tackled the challenge of convenience head on. We recognized that if a member could talk to a service advocate as soon as possible, they can get their questions answered, get the education they need or get connected to a clinical case manager before a small issue becomes a big one.”

For more information, check out the Leap plans.