Health plan perspective - Aetna

Tuesday, March 01, 2016 12:17 PM

Aetna and Humana: Working together to accelerate health care transformation

by Gina Conflitti, MD, Regional Medical Director, Aetna

The model for providing health insurance is undergoing a fundamental shift in the United States. The health care industry is rapidly transforming amid a highly competitive environment where new companies are continually entering the market, providing consumers with more flexibility and choice than ever before. After the Aetna-Humana transaction closes, Medicare beneficiaries will continue to have access to a broad choice of products and high quality, affordable health plan options. It is estimated that only 8 percent of seniors receive their health benefits from Aetna or Humana, meaning that 92 percent of all beneficiaries receive their health benefits from traditional Medicare or other Medicare Advantage plans.

At Aetna, we envision a world where health care is focused on the consumer. A world where our ability to analyze data to see what health issues are most prevalent in a community can be coupled with Humana’s ability to put more nurses and clinicians in people’s homes. One where Humana’s commitment to long-term health is bolstered by Aetna’s deep partnerships with community organizations across the country. Our combination will bring this vision to life, pairing two complementary companies that will be better equipped to serve the dynamic needs of patients, families and providers.

Consumers seek a simplified experience that engages them in their health and offers greater transparency and convenience. A recent survey found that eight in 10 Americans believe a consumer-oriented approach to health care is good for the nation, and 60 percent say they prefer to take a lead role in decisions about their health care. We look forward to creating a shopping experience that will enable consumers to easily compare plan prices and benefits and understand upfront how much they would pay. The insights of Aetna’s existing services like ActiveHealth and Denver-based iTriage – which provide individuals with advice on how to manage their health – could be combined with the capabilities of programs like Humana Vitality, which reward individuals for taking steps to become healthier.

We are also focused on building a first-class health services business, where we work with providers to create value-based payment arrangements that improve care and lower costs. Aetna’s goal is to have 75 percent of medical spending in value-based payment arrangements by 2020. Provider partnerships with Centura and Physician Health Partners are already showing real results in Colorado.

Combining these companies will enable Aetna to offer consumers more accessible, affordable, comprehensible coverage options. Ultimately, we believe this transaction will allow us to increase the number of healthy days our members enjoy each year.