Aetna combats chronic conditions, med non-adherence with mHealth


The world of mobile health offers many advantages for payers to help keep their members healthy, which leads to less healthcare utilization and lower costs. The folks at Aetna have taken that awareness to heart in creating their new CarePass platform, which provides consumers access to health and wellness apps from one online hub.

Most recently, CarePass expanded its offerings to include tools that track medication adherence and stress. To learn more about why Aetna chose to focus on those areas, plus hear about how Aetna intends to expand the CarePass platform, FierceHealthPayer spoke with Martha Wofford (pictured left), vice president of Aetna and head of CarePass.

FierceHealthPayer: Why is medication adherence and stress reduction important focus areas for Aetna and its Care Pass platform?

Martha Wofford: We're really trying to make access to healthcare and access to healthcare information more convenient for more consumers. One of the trends that we look at and are really concerned about is around the rise of chronic conditions, particularly obesity. We look at the fact that one third of adults are obese, which brings about multiple chronic conditions, and have been thinking about how we can provide consumers easy access to the best apps out there around nutrition and fitness and sleep. If you're not sleeping well, then you often aren't exercising, and if you're not exercising then you're often not eating well. So it's all related, connected and important.

Another key aspect is looking at the costs of people with chronic conditions. Eighty-four percent of all healthcare costs are associated with folks who have chronic conditions, which is a pretty amazing number. Just five years ago, about 75 percent of costs were based on a person's last year of life. But that has really shifted as people are getting chronic conditions younger, living with them longer, and it's causing them and the system a lot.

And then on top of all that, half of all people who are on a medication for a chronic condition stop taking that drug within a year, costing the system an estimated $290 billion each year. That really draws your attention to the issue of non-adherence and what we need to do about it.

On the stress side, there are similar trends. A quarter of U.S. adults characterize themselves as stressed or highly stressed. And when you're stressed, you're not sleeping well, you're not exercising, you're not eating well. It all has a negative impact and increases this negative cycle.

FHP: How do you at CarePass decide what new apps should be added to the platform? Do you decide on an issue that you'd like to address first or do companies reach out to Aetna?

Wofford: It's a mix. We do have a lot of inbound interest, which is great, but then we have to sort through those. We have criteria about who we will partner with, a key aspect of that is the number of downloads and users. Some of our apps have 25 million downloads and users, so we're definitely trying to connect apps that are clearly working in the market for people and have them be part of the CarePass ecosystem. But we're also trying to support innovative, new solutions that we think may have an impact. So it's really a combination. Philosophically, we're really about choice. How do we create an open environment where we have choice for people and it's not focused on one brand, one product or one app?

FHP: What does CarePass do with the data gathered through all the apps it offers? For example, does anyone at CarePass monitor trends for Aetna members?

Wofford: Not at this point. It's definitely part of where we'd like to get eventually. We send care alerts to members through our personal health record program and those alerts actually drive a lot of our engagement. How you deliver that information is also important and so it has to be well thought through. At this point, CarePass is enabling the consumer to connect their data and it's not so much enabling other parts of the healthcare system.

I think that's a direction a lot of people would love to see us go and we may get there, but there's a lot we want to do to empower consumers first. We're working on the data being delivered back to the individual in a personalized way to let them take the steps on a daily basis to live as healthy a life as possible. Trying to understand how, for instance, your sleep is correlated with your diet and nutrition and medication adherence.

FHP: What would you say is the value that CarePass and all of its apps provides to Aetna?

Wofford: Many of the reasons that we're doing this have to do with the larger issues and challenges in the industry. Part of it is a responsibility we feel to address some of these major problems in the system. We also believe that in a world of exchanges and consumers making more choices, having consumer tools that people find value in will have value for us in the long term. So there's sort of a brand enhancement perspective that we have in the long run.

A lot of this also drives out of CEO Mark Bertolini's passion in harnessing technology to improve the experience. He's been a patient and the parent of a patient and he knows how frustrating it is to be on that side of the equation versus being a CEO of a health plan with lots of data. So the question is how do we empower people with their data? It's doing the right thing for the right reason. 

FHP: How successful has CarePass and its apps been for Aetna?

Wofford: Overall, for the CarePass integrated apps, the downloads are more than 100 million. We started around the most popular spaces in mHealth--fitness and nutrition really dominate. So those are where you get the most downloads. But I think as an industry, there's still a lot we have to do to create meaningful solutions for patients. As you start to get into areas that are more clinical in nature, those apps tend to have less traction. We have a lot to do to make the solutions better and make them more integrated into the provider workflow and, therefore, have a greater impact.

The point of all this is to try to bring together different components of a person's health to see that broader picture. This is an example of continuing to expand the components of whole health.

- Dina (@HealthPayer)

Editor's Note: This interview has been edited and condensed for clarity.