Dale Mackel Market President Coventry Health Care, an Aetna company
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Dale Mackel Market President Coventry Health Care, an Aetna company What to Expect from Health Insurance in the Future
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What to Expect from Health Insurance in the Future. Dale Mackel Market President Coventry Health Care, an Aetna company. ACA Impact on Health Care Industry is Unprecedented. Disruption Innovation Transformation. Today’s Topics. As a carrier, Coventry/Aetna will focus on: - PowerPoint PPT Presentation
Transcript of Dale Mackel Market President Coventry Health Care, an Aetna company
Dale MackelMarket President
Coventry Health Care, an Aetna company
What to Expect from Health Insurance in the Future
ACA Impact on Health Care Industry is Unprecedented
Disruption
Innovation
Transformation
Providers
PractitionersBrokers/Exchanges
Carriers
Today’s Topics
As a carrier, Coventry/Aetna will focus on:• Empowering the consumer• Innovating the Care Delivery System• Changing how insurance is packaged & purchased• Supporting ACA law evolution to preserve the goal of
accessibility, affordability and sustainability
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Empowering the ConsumerShift from B2B to B2C. For the first time, the consumer will be an informed buyer of health care services• Enablers will be technology and transparency
– Mobile platforms that facilitate symptom-to-service capability (Aetna’s iTriage app)
– Powerful self-service tools that put more control into the hands of consumers
– Price list for services at network providers (may even be variable based on supply & demand)
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Consumers want more health, not more treatment
Care Delivery InnovationBuilding new network models to drive quality, affordable care• ACO’s, HPN’s, Narrow Networks, Patient Centered
Medical Homes– Primary care physician will navigate patient through the
health care delivery system– Quality/Efficiency/Outcomes – how the delivery system
will be measured and compensated– Networks customized for certain industries (hospitality)– Must be of value to the consumer
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Goal is not to Pay Less for Care but to Pay for Less Care
How Insurance will be Purchased/PackagedPublic and private exchanges will influence purchasing dynamics
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• Exchanges are here to stay• Public exchanges will become more functional over
time and proper for subsidy eligible consumers• Private exchanges will innovate & flourish
– Offer exceptional on-line consumer buying experience (Amazon, Priceline)
– Keep employers connected to employees from a benefits perspective
– Customize insurance plan offerings based on individual circumstances
Supporting ACA Law Evolution Restore consumer choice & relevancy for small companies & individuals• Essential Health Benefits are a good start, but benefit
flexibility is required to strike a proper balance among coverage, cost and need (over-insured)• Rating Algorithm Enhancements• Incentives to attract young healthy population into the
insurance pool• Consumer needs should drive changes in the law
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