The current health care system in the United States is broken; it fails too many people, Aetna Chairman and CEO Mark T. Bertolini said at the CECP CEO Investor Forum. There’s overspending on health care, the quality of care is poor and chronic conditions are poorly managed.
It’s imperative to address these issues to ensure people live healthy lives. That’s why Aetna is taking a holistic view of health and helping members achieve their health goals. A healthy individual is productive; a productive individual is socially, physically, spiritually and economically viable. And viable people are happy, Bertolini said.
“When you think about your own health, it’s what my health prevents me from doing in life that I really want to do,” Bertolini said. “… We want to understand what your journey is and we want to engage you in your project.”
The current health care system has a narrow focus on clinical care that is general and not personalized for each unique person, Bertolini said.
“Your zip code matters more than your genetic code when it comes to how long you’re going to live,” Bertolini said, noting that 60 percent of a person’s life is impacted by social determinants of health.
By looking at a person’s social and environmental factors, their behaviors and the clinical care they receive, Aetna is adopting the definition of health established by the World Health Organization in 1948:
“A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Aetna is using its analytics to better understand members’ health, as well as providing next generation digital tools and access to local care teams and community touch points. The company is also partnering with various health systems across the country to form joint ventures, providing quality care and better outcomes at lower costs.
These initiatives, Bertolini said, will help give members personalized care for their unique needs.
“If we win … then the customer should win because we’re focused on improving the health of those members to drive downs costs,” he said.
Acknowledging the opioid epidemic in the U.S., Bertolini described how Aetna is helping to fight the crisis. Earlier this year, the company published its opioid strategy paper, outlining its five-year goals aimed to prevent misuse and abuse, allow for intervention when at-risk behavior is identified and support patients who are addicted with access to evidence-based treatments.
In August, Aetna provided 720 doses of Narcan to first responders in the Northern Kentucky and Appalachia regions to help prevent opioid overdose-related deaths in the area.
And in May, the company sent letters to 480 dentists and 249 oral surgeons in the U.S. for prescribing large amounts of opioids. The move was a continuation of a 2016 initiative, when Aetna identified nearly 1,000 “super-prescribers,” or doctors that were refilling opioid prescriptions at a higher rate than their peers.
Bertolini also described how Aetna does well, by doing good. In 2015, Aetna launched it’s “Social Compact,” which includes improved wages, enhanced benefits and innovative wellness programs.
In January 2015, Aetna increased the minimum hourly wage for U.S. employees to $16 per hour. The change affected about 5,700 employees. Aetna also launched an enhanced benefits program, helping lower out-of-pocket health care costs for thousands of eligible employees in the U.S.
And in August 2016, Aetna announced a student loan repayment program. In January 2017, the company began matching loan payment contributions for full- and part-time employees, who graduated after Dec. 1, 2013.
“We implemented a new economic model that invests in our employees’ well-being so they can engage with their work and take care of our customers,” Bertolini said at the CECP event.