Tuesday, March 25, 2008

Check Out What Aetna is Up To

If you’ve been reading Joe Paduda’s blog (it's a new blog link on the right), you may already be aware that Aetna’s stock avoided the recent market drubbing experienced by some other big health insurers. So, when a transcript from a recent Analyst Meeting became available, the Disease Management Care Blog donned the extra thick reading goggles, warmed up the coffee and read and searched for the ingredients behind Aetna’s recent success. Much of the presentation was all about underwriting, cost controls, market segmentation and exceeding customer expectations (and not using healthcare industry benchmarks by the way), but scroll on down through all that 6 point font and check out what CMO Troyen Brennan had to say.

Or, don’t read it and rely on this bulleted summary provided gratis by your ever faithful DMCB:

  • They are converging disability, pharmacy, behavioral health, electronic medical, hospital, any clinical and its own claims data in algorithms to compare and contrast their providers’ care vs. best practices. They’re committed to continuing to use this information to influence patient and physician behaviors in many ways to reduce variation and increase quality.
  • They are not worrying at all about the cost of an army of 2,500 health professionals who are responsible for interlocking wellness, disease management, pre-certification, concurrent review and case management laced with coaching and advocacy. They feel they and their customers are getting their money’s worth.
  • Despite hostility from state Attorney Generals and organized physician groups, they are throttling full speed ahead on Centers of Excellence, preferred networks and patient steering. Transparency may help diminish the enmity, but from their customers’ point of view, the savings are just too compelling.

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