Sunday, December 07, 2008

Banking with Aetna

This was announced back in April and was covered by the WSJ Health Blog, but I am just now getting around to it, as its effective date is January 1. The deal is that Bank of America hired Aetna to manage all of its employee benefits for 200,000 staff members nationwide. Of course, it covered the administration of the health care insurance function, but it also includes a concierge service for health coaching, on-line risk assessments, and integrated data management to monitor trends and deliver better preventative and chronic care.

But check this out, "Besides the white-glove service, Aetna has pledged to meet targets for paying claims accurately and controlling medical costs. Otherwise, the insurer will have to pay penalties to Bank of America."

I don't know if any other businesses have since signed up with Aetna. And I don't know if other insurers offer similar services or have secured deals with other large employers; but if I were running a smaller insurance company in a region characterized by nationally based employers, I would be nervous.

And an open question for Aetna and Bank of America, do you monitor the actual quality and safety of care delivered by providers in each city to help steer employees to the ones with better documented results?

4 comments:

The Medical Quack said...

Marketing and pilot programs appear to be getting very strange at times and yes you wonder how all this will work. Here's an odd one where Aetna started a pill lottery. Again, sometimes I scratch my head on some of the marketing and other programs being initiated.

http://ducknetweb.blogspot.com/2008/08/aetna-your-pill-lottery.html

MC5 said...

There is a much better way to finance health care by employing some of the innovations that the big banks have pioneered in recent years:
http://www.ritholtz.com/blog/2008/12/how-to-pay-for-national-health-insurance/

Anonymous said...

So an insurer has to be incentivized to pay claims accurately and control medical costs. My, my, what will they think of next? Bonuses to the insurance company for actually answering a question on the phone or for clearly explaining the covered benefits in terms a normal human can understand.

The Medical Quack said...

I found one other recent post in my archives here that is somewhat confusing as well and relates to Aetna and Costco. Being a geek and using and reviewing all of this, it was terribly confusing to me, so how does the average user view this?
I had several on Twitter agree as I put it out there to see if it was me or if it really was the confusing as I have bad days here and there too:)

http://ducknetweb.blogspot.com/2008/11/aetna-and-costco-create-yet-another.html

It does make you wonder how some of these program get started and where lines are crossed. With the wellness programs there are areas to where some of this can conflict with what a physician recommends too. Some companies now due to the cost of health insurance and breaks offered by the insurers are making participation mandatory. One other item too that comes to mind though is how far will the wellness program go before it becomes intrusive rather than constructive. Not that I am a real skeptic, but rather when medical devices appear on the market that appear to lower the costs, who's to stop their integration into the health system as there is really nobody minding the store on so much of this.

http://ducknetweb.blogspot.com/2008/11/employers-in-search-of-ways-to-help.html

When I read stories of pilot programs with kids now having to wear monitors to help curb their behavior, I think it has gone just a little too far in not letting kids be kids. Here's the link on the story for the children wearing heart monitors in the UK and they are starting this at age 7. Again, things that just get started out there behind the scenes and the next thing we know we are living with it.

http://ducknetweb.blogspot.com/2008/11/intrusive-technology.html

Anyway, just some of my thought on where some of this could lead and what the participation with wellness programs could grow to in the future.