The Affordable Care Act has "broken up the black box of managed care insurance," Aetna CEO Mark Bertolini said in an interview with Forbes, so he's leading the charge to improve healthcare quality and control costs through high-tech products, such as mobile apps, expected to create more than $1.5 billion in revenues for Aetna next year.
Leading through technology is a sea change for a traditional business like Aetna, Forbes noted. "We've been underwriting risk for 163 years, and the formulas haven't changed in 163 years. Some say we have actuaries who have been around for 163 years" Bertolini deadpans. "It's difficult moving the model."
But the model is moving as Aetna's interventions work to nudge the industry ahead, according to Forbes.
Three examples: Aetna piloted a concierge service that resulted in a 49 percent dip in inpatient readmissions for congestive heart failure. The service has cardiac patients step on a wi-fi scale and use blue tooth technology to monitor arterial blockage. Signals of slowed heart and retained water go to an off-site nurse, who makes a home visit, adjusts the patient's medications, and rolls up rugs to prevent patient fall at home.
Then there's the free iTriage app, which lets customers manage their health information, such as tracking medications.
Finally, there's Healthagen, a business Aetna created to support new companies addressing healthcare needs and offer tools for providers, employers, payers and customers to improve care and control costs.
Other payers are investing in mobile apps to promote health and improve clinical outcomes. For example, Cigna partnered with Samsung to create an app to deliver health information to customers and connect them with caregivers. And insurers continue to enhance their mHealth offerings as diet, exercise and wellness apps become wildly popular with customers.
However, only 22 percent of health plans who offer mobile apps allow customers to access their healthcare data on the mobile web, as FierceMobileHealthcare previously reported.
- read the Forbes article