Yahoo Finance
July 23, 2017
Two life-threatening
medical challenges have shaped how Aetna (AET)
CEO Mark Bertolini views the health care system and how he’s changing the
approach to improving the patient experience.
In 2001, Bertolini’s
son, Eric, then 16, was diagnosed with a rare and deadly form of lymphoma.
Bertolini left his job at the time as an insurance exec at Cigna to be by his
son’s hospital bed. Today, his son is the only known survivor of the disease.
In 2004, a year after his son returned home, Bertolini suffered a spinal cord
injury in a horrific skiing accident. He is partially disabled. He also donated
one of his kidney’s to his son in 2007.
“The biggest message
out of all of those for me was that the health care system fixes what’s broken,” Bertolini told Yahoo
Finance. “So, for me, it was a broken neck and a macerated brachial plexus, bad
nerve damage. For my son, it was his cancer. But when they were done with that
work, thinking of me as a whole human being, engaging in my own life and being
back in society in a way that was productive and useful for me was not on their
agenda.”
What Bertolini learned
was that the journey after leaving the hospital could be “very murky and difficult
to navigate.”
Building programs beyond just paying for acute
care
This experience led
him and Aetna to take a more holistic approach to health care, pointing to the
1948 definition of health defined by the World Health Organization as “a state
of complete physical, mental and social well-being and not merely the absence
of disease or infirmity”.
“As I tried to put my life back together, as I
tried to advocate for my son when he had his cancer, it became apparent to me
that we have big holes in the health care system that we need to fill in
some way and that we need to treat people as whole people. We need to make sure
that they’re rehabilitated back to a life they enjoyed. And so we started
building programs beyond just paying for acute care,” Bertolini said.
This approach involves
looking at how people live their lives, where they reside, and if they’re able
to be productive members of society.
“We redefined health
as a healthy individual who is productive. A productive individual is socially,
spiritually, economically, and physically viable and viable people are happy,”
Bertolini said. “And so we should be making people happy because they’re
productive members of society.”
Zip code, not genetic code
He pointed out that
longevity, the length of one’s life, approximately 10% is related to clinical
care, 30% is related to genetic code, and 60% is related to where one lives,
meaning social determinants and lifestyle factors.
“Longevity is very
much defined by your zip code, not your genetic code,” Bertolini said, “We have
zip codes in this town, in New York, we have zip codes in Detroit, we have zip
codes in Chicago where individuals in one zip code have fifteen to twenty years
less life expectancy than people in the zip code next door.”
Aetna decided to get
into the communities to understand the social determinants. The insurer started
building programs ranging from urban farms to
eliminate food deserts to yoga-mindfulness in inner city schools to help students
focus on their studies.
In addition to these
sorts of programs, technology is another factor that’s playing an increasing
role in creating healthier communities.ping people.
One of the next big
trends will be in-home monitoring through wearing devices. This will provide information
where someone within the community can check in on their friends, family, and
neighbors.
He compared it to
logistics used by companies like UPS, FedEx, Amazon, Uber, Lyft, and Airbnb.
“They don’t own the
means of production, meaning they don’t build the product. They don’t owe the
customer other than to connect the customer to the product,” Bertolini said.
“So if you think about that tool in health care, if we can get inside the home
with monitoring, instead of knocking on the door and saying, ‘We’re here from
Aetna. We’re here to help,’ if we can get information from that allows us to
understand demand —what do they need in the way of help? — and source that in
the local community, we can create economic viability in the community by
having people in the community supporting people in the community in their
homes.”
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