The Radical Goal of the CVS-Aetna Deal, According to Aetna’s CEO
Mark Bertolini, CEO of insurer Aetna, spoke at length on what he believes is the right way to create a more efficient, personalized medical system and delivered insights into retail giant CVS’ blockbuster proposed deal to buy his company during the 3rd annual Fortune Brainstorm Health conference in Laguna Niguel, CA on Monday.
“People never describe themselves as a disease. But they may have limitations because of their disease,” Bertolini told Fortune editor-in-chief Clifton Leaf during a one-on-one interview. “That’s the problem with ‘population health’—everyone’s part of an average population, so we make them all the same instead of focusing on personalizing their care.”
Subscribe to Brainstorm Health Daily, our newsletter about the most exciting health innovations.
Instead, Bertolini says, a smarter way to approach Americans’ health care is to put their needs front and center and construct a business model around those needs—one that’s less complicated than the fragmented, expensive medical system that currently rules the U.S. In part, that’s the kind of goal that could theoretically be chipped away at with a corporate marriage like CVS-Aetna, which would pair a pharmacy chain with ubiquitous presence around America with the country’s third largest health insurer.
“Build a marketplace for a community around health,” said Bertolini. “Why not eliminate benefits as a notion? Let’s say, we’re going to do what we can in the community to help you, we’re going to build a supply chain, and that supply chain is going to provide you a service at a better cost.”
Under the model of such a “patient-centered medical home,” for instance, health care providers could give people practical (and personally tailored) advice on the “next best action” they may be able to take in order to improve their health, perhaps by improving their diet or boosting how much exercise they get. This essentially flips the medical model on its head, says Bertolini. Rather than asking patients to blindly provide doctors and the health system a bunch of data that is then used to deduce their needs, patients and providers could work together to create an action plan.
As for worries about how much data Americans would have to share in order to make such a system work? Bertolini isn’t worried, arguing that patients would be willing to provide access to this data as long as they get a tangible value proposition in return.