How Aetna harnesses its data to help breast cancer patients
Payers have so much data available to them that they can create all kinds of valuable programs and projects that serve their members. At least that's what Aetna thinks--and it's the belief driving its new program, called Aetna CarePal. The pilot, which launched Oct. 1, connects members who have recently been diagnosed with breast cancer to members who have already survived the disease. The insurer aims to help its members address the emotional impacts of cancer in addition to all the physical issues.
"Payers do have a wealth of data that can be used to really help people," Greg Steinberg, head of clinical innovation at Aetna, told FierceHealthPayer in an exclusive interview. "You can actually bring people together to have the most productive and meaningful conversations on a go-forward basis."
To learn more about this program, FierceHealthPayer spoke with Steinberg as well as Aetna's Michael Kolodziej, national medical director for oncology strategy, and Jess Jacobs, director of innovation.
FierceHealthPayer: Can you describe the key elements of the CarePal program?
Greg Steingberg: The concept of somehow having patients talk to other patients that have similar issues in and of itself isn't new. But what I think is the new, innovative and hopefully important angle about this is that we're leveraging the significant amount of data available at the payer level to proactively match people up more effectively so their ultimate discussions are more fruitful. We can match up individuals who have had breast cancer with other individuals who are relatively new to the disease, and are also similar demographically and relative to their family status and general makeup. That activity can be done through the data analytics. That's the secret sauce, if you will.
Jess Jacobs: Essentially, from an operational perspective, we're having individuals come to the registration website and sign up for the program, so we get a little bit of data there. Then, on the back end, we're able to match it with comorbidity and other things linked to claims data, so we can have a more complete profile of the individual. We take that information and get the best possible match between a new condition individual and someone who has already gone through treatment.
Things we're matching on include comorbidity as well as social factors--whether you're married, if you have kids and how old the kids are, whether you're employed and what type of job you have, and other high-level things. We're also looking at ZIP codes, because there are differences based on geographies. Then there are 10 questions asking what they would like to talk about. There, we want to match people who are new to the condition and want to talk about a specific topic with someone who is experienced with the condition and also has experience based on those answers. We can tell that they know something about XYZ subject.
Michael Kolodziej: I was a practicing oncologist for over 20 years, and I had the pleasure of taking care of many breast cancer patients. Patients do get a lot of information from other patients. The format by which that exchange of information occurs is both formal and informal. In the treatment room, it's really interesting to watch the dynamics of how patients interact with each other. They talk all the time. What I think is absolutely ingenious about this project is the idea that you can help people talk to the right people and eliminate some of the barriers that might inhibit them from initiating a dialogue because of who they are or where they are.
It's very clear that breast cancer in a 35-year-old woman is very different than breast cancer in a 65-year old woman. There's a lot of reasons for that. It's actually a different disease biologically, and certain factors like fertility are important depending on the patient's age. As we thought about the clinical factors to match, I was sensitive to my experience of what matters in terms of how a patient would navigate her way through the journey. We learned to make sure that we allow apples to be sorted with apples.
FHP: Why did you choose to focus on breast cancer in this initial CarePal pilot?
Steingberg: We have an internal "innovation challenge" that we open up to Aetna's 30,000-plus employees to come up with something that they feel is innovative and that we could potentially pursue. The idea that won was this idea, and the person who put the idea forth is actually a lawyer who works at Aetna who has a child with autism. Initially, we were looking at autism, but we felt we wanted to start with something that, unfortunately, has a fair amount of statistical prevalence and where we felt there was a lot of emotional overlay to this whole diagnosis on the part of women who receive it, as well as the need to communicate with others like them. We felt that, from both those perspectives, this was a good place to start. That said, the plan would be to enlarge the concept to other conditions such as autism.