Aetna CMO: Harness the power of scale to cut costs, improve outcomes
Guest post from Harold M. Paz, M.D., Aetna's chief medical officer
While there are many viewpoints on the best way to fix our healthcare system, we can agree that a better system means bringing the best practices of medicine to as many patients as possible. The thousands of doctors and nurses that work at health insurance companies nationwide are in a unique position to help achieve this goal. We can work together with healthcare providers to innovate and improve care, then share what works across a wide range of settings to positively influence care at a broader level. We can also help address gaps in care, particularly for seniors and those with chronic conditions.
In my former roles as a medical school dean, as well as CEO of two medical group practices and a large health system and medical center, I was always proud of the care we provided in our local communities. These organizations improved patient access and satisfaction, reduced costs and transitioned to a system of population health management in their respective regions. But while we made the people around us healthier, our impact would always be limited by two factors--our geography and the size of our organizations.
Aetna's connection with more than 1.1 million healthcare professionals, including more than 675,000 primary care doctors and specialists and 5,600 hospitals, gives us the opportunity to help improve care in more places. Our collaborative relationships with healthcare professionals--focused on quality of care for patients--have improved health outcomes and lowered costs. Our proposed acquisition of Humana will enhance our capabilities and allow us to accelerate the transformation of the healthcare system.
Collaborating with healthcare providers
We need to continue changing the relationship between health insurance companies and healthcare providers. We are already moving away from what used to be adversarial relationships and realizing that the best results for everybody involved--especially patients--are achieved when we are working together.
Our work with Inova, a health system based in Northern Virginia, is an example of what is working now and what the future could look like. It is a true joint venture, as together we created a new health insurance plan--Innovation Health--that is offered to consumers and businesses in Northern Virginia. Working together allows us to offer one of the lowest-priced plans in that market, and we now have more than 170,000 members in less than two years. One way we brought down overall healthcare costs was by reducing unnecessary and costly care. After one year with Innovation Health, one large employer had 15 percent fewer people admitted to the hospital, shorter hospital stays and 20 percent fewer people ending up back at the hospital after going home.
More importantly, our collaboration with Inova and willingness to share clinical data has helped us improve the quality of care for health plan members receiving care at Inova facilities, and reduced costs by enabling patients to receive the most appropriate care. For example, hospital admissions of Innovation Health members for C-sections have decreased by 27 percent since we launched our joint venture. Physicians have also prescribed generic drugs 21 percent more frequently during this time.