WASHINGTON – Aetna Inc. Chairman and CEO Mark Bertolini on Thursday advocated dramatically changing how providers and insurers are paid as a way to reform the fee-for-service model.
Speaking at the non-partisan Peterson Institute for International Economics, Bertolini outlined his company’s plans for battling rising health care costs. The first stop for Aetna: fixing the health care reform law.
The law “does nothing about affordability in any real ways. In fact, it drives the costs up,” Bertolini said.
The leader of the nation’s third-largest commercial health insurer said Aetna has called on the industry and government to implement an individual mandate for coverage.
The Supreme Court is expected this summer to hand down a decision regarding the constitutionality of requiring individuals to purchase health insurance.
Without a fundamental shift in how providers are paid, though, the law, as it is written, will not work, Bertolini said.
Bertolini reasoned that the health care reform law will push younger, healthier people out of the market as the penalty for not buying insurance is low and at least 60 percent of Americans will have to pay higher premiums in 2014.
The company has been aggressively developing technology to make health care more consumer- and patient-friendly, Bertolini said.
Aetna implemented iTriage, a free app that brings all of a consumer’s health care information, such as prescriptions, doctors, and lab tests to their phone or computer. The app is free and not exclusive to Aetna.
Bertolini said he believes that allowing Americans to become consumers before they become patients will enable the system and providers to work better and manage risk.
Regardless of the Supreme Court’s decision, Bertolini does not expect any significant change in the law or health care delivery until after the election. He called “for better political leadership in the dialogue” rather than one that vilified the industry.
Aetna has 5-7 percent of the marketshare and Bertolini said the company is well-positioned post-health care reform. Aetna’s profits fell 13 percent in the first quarter, missing Wall Street expectations.