Aetna CEO: Supreme Court ruling won't dramatically impact payers

Aetna CEO Mark Bertolini said the Supreme Court ruling on the law's constitutionality won't dramatically impact payers because they would have needed to implement many of the law's changes "in order to be competitive in the marketplace anyway," he told The Wall Street Journal.

"If the Affordable Care Act were to go away tomorrow, we still would be better off as an organization because who can argue with getting a lower healthcare delivery cost, more streamlined administrative structure, making yourself simpler and less complex to do business with?," Bertolini pondered. "Our view is this is just an action-forcing event, through which we can drive some change, not only inside our company but across the industry. That otherwise wouldn't have happened."

That viewpoint may lend some insight into Aetna's decision last week to uphold some reform provisions regardless of the Supreme Court's decision. The insurer, along with UnitedHealth and Humana, vowed to preserve some of the law's most popular provisions that have taken effect already, including allowing young adults to remain on their parents' health plans, covering preventive services and maintaining a simpler, independent appeals process.

"The Supreme Court case, from my perspective, is important in its constitutional role but has far less impact on the Affordable Care Act than I think the American public and the political blogosphere is giving it," Bertolini added.

Looking to the future, Bertolini said industry collaboration is key to cutting costs. "I think it's not us alone. It has to be us with the providers, and it has to be in an open and transparent, databased way that we can work together to leverage each other's capabilities," he said, noting that "requires a level of trust and partnership that the industry has not seen before."

Aetna also plans to continue acquiring technology-focused companies, Bertolini said. Aetna acquired Healthagen, the company that developed mobile app iTriage, last December, and it bought Medicity, a health insurance exchange company, in April 2011.

When it comes to consumers, all payers must "redefine quality in healthcare as convenience," Bertolini said. To that end, he thinks the industry will create an open market similar to the restaurant industry's online reservation service OpenTable. Then, providers can post availability and consumers can sign up for appointments and services.

To learn more:
- read the Wall Street Journal article (subscription required)

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