Even though health care spending in the U.S. reached $3.3 trillion per year in 20161, patient outcomes and mortality rates remain dismal. Care coordination and transparency around patient data continue to be a struggle. A transformation is desperately needed to cure our ailing health care system.
Insurers and providers should be working together to bring their strengths to bear on improving patient outcomes and reducing costs, according to Brigitte Nettesheim, President, Joint Venture Market Operations, Aetna.
“Aetna wants to be part of the solution,” Nettesheim said during a panel discussion at the recent Healthcare Information and Management Systems Society (HIMSS) meeting in Las Vegas. “How can we convert investments in health care to better outcomes in health care?”
Nettesheim spoke as part of the “Lessons Learned: Transformation Across Large Healthcare Communities” panel at the HIMSS Annual Conference & Exhibition in Las Vegas March 7, 2018. Panelists discussed what can be done to achieve real and lasting change in health care. Nettesheim focused on Aetna’s transformation from a health insurance company to a health company, noting that this change requires a focus on the consumer experience.
Nettesheim joined Ashwini Zenooz, M.D., Chief Medical Officer, Electronic Health Record Modernization, Department of Veterans Affairs; Tricia Nguyen, M.D., Chief Executive Officer, Inova Commonwealth Health Network; and Kevin Carr, M.D., Partner and Chief Medical Officer, PricewaterhouseCoopers Public Sector, to share lessons learned in achieving sustainable change.
“If you look at the number of organizations at this conference, there is a wide plethora of changes going on within each one of those organizations, not just from a technology perspective but also from a business perspective,” noted Dr. Carr.
He added that transformation starts with what’s known as the Active Continuous Transformation (ACT) framework, which includes developing a vision for change that occurs within ‘guard rails’ which become standardized over time. Key performance indicators help to determine if strategies to achieve change are actually working.
As a large health care company, Aetna is creating innovative ways to work with doctors and other providers to deliver greater value to consumers. In pursuit of this ambition, Aetna is partnering with provider organizations to improve health outcomes, decrease care costs and provide a more streamlined patient experience.
“What does our evolution to a health company mean? It means paying for services and treatments that lead to better outcomes,” Nettesheim said. “It means focusing on consumers and not just the business of health care.”
With a keen focus on serving members’ overarching health care needs and boosting affordability, these provider-insurer joint ventures are aiming to transform health care in the U.S.
Panelists went on to discuss how to “ACT” to achieve lasting change, including the importance of forming teams that have full leadership support, maintaining internal momentum and commitment to change, renovating organizational structures and processes to ensure change lasts and using new technologies to undergird all of this work.
1 NHE Fact Sheet, Centers for Medicare and Medicaid Services, February 2018.