NewYork Presbyterian CEO: Aetna exit shows need for increased subsidies

It’s been a bad few months for the Affordable Care Act, with Aetna making the latest in a series of high-profile exits from the law’s exchanges, but the CEO of one of New York’s top hospital groups says these withdrawals illustrate the steps necessary to improve the law’s implementation.

“What's happened in the individual insurance marketplace and the exchanges is first, the patients have been sicker,” Steven J. Corwin, M.D., CEO of NewYork-Presbyterian Hospital Group, told USA Today. “That tends to drive premiums up. The ability to expand the amount of premium increase has been limited. The consequence of this is the insurance companies are losing money.”

The only way to stop the bleeding for health payers, he told the publication, is to increase insurance subsidies enough to attract a healthier patient population. At NewYork-Presbyterian, he added, leaders are working to attract both the top talent in the industry and attract consumers to expand its patient base.

In the meantime, however, the increased consolidation within the payer industry isn’t helping matters, Corwin said. While a certain degree of consolidation is good for the healthcare business, he told USA Today, over-consolidation, such as the proposed merger between Aetna and Humana recently challenged by the Justice Department, reduces competition on price to a problematic degree.

Corwin contrasts that with concerns about consolidation within the healthcare sector, noting that in many cases, hospitals take over providers that wouldn’t otherwise survive. He adds that a full, comprehensive level of population health management will require consolidation to some extent. This holds particularly true in the New York marketplace, he told the newspaper, which is competitive enough that consolidation doesn’t hurt competition levels.