Ready Today for the. Brian Kelly, MD Aetna National Medical Director. Future of Health Care

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1 Ready Today for the Brian Kelly, MD Aetna National Medical Director Future of Health Care

2 Aetna s Leadership Strategy Quality Creating Value Health Literacy Transparency Evidence-based Engaging Consumers, in Concert with Providers, to Achieve their Optimal Health Affordable Products Influencing Public Policy Aetna

3 Aetna s QTC Strategy Quality and Total Cost is: Clinical orientation Reliance on hard medical evidence base Comprehensive flow of integrated data Decision support to both physicians and members Commitment to identify and improve the quality of care particularly those with multiple chronic conditions Aetna

4 The Next Generation Quality and Total Cost Strategy Framework for Operationalizing the QTC Strategy HEALTH INFORMATION TECHNOLOGY BEHAVIOR CHANGE WITH PROVIDERS Aetna Pathways to Excellence Next Generation Provider Collaboration Integrated Solutions Aetna Aetna Healthy Actions Aetna Health Connections BEHAVIOR CHANGE WITH MEMBERS EVIDENCE-BASED MEDICINE

5 Medical Pharmacy Lab Behavioral Health Risk Assessment Health Demographics Disability Physician s Electronic Medical Records Lifestyle Coaching Tobacco Cessation Weight Management Stress Reduction Referrals to Disease Mgmt Patient Safety Program Condition Management Member Outreach Targeted Wellness Reminders PHR Alerts Physician Outreach Disease Management Single nurse model 37 Conditions Active Advice Custom Scripting Referrals to Lifestyle Coaching Engagement Personal Health Record Maternity Management Pregnancy Risk Survey Case management is available for Supportive, At Risk, and High Risk members Post partum outreach calls to At Risk and High Risk members Core Utilization Management Services Pre-Certification, Case Management, Concurrent Review, Discharge Planning Aetna

6 A solution that supports your employees at every stage of health Stay well (mind and body) Identify and manage health risks to prevent disease and disability Reduce absenteeism and on-the-job productivity loss Manage/mitigate disease impact Identify and manage those most at risk for disability Provide structured programs to support return to health and productivity Manage medical care Manage disability Access to Quality Care Aetna

7 Condition Management 1 Program - 39 Conditions 1 program; 39 conditions Customized assessments and action plans Single Nurse Model Provides 360º view of 100% of members, 100% of the time Vascular Cluster Peripheral Artery Disease Congestive Heart Failure (CHF) Diabetes (adult and pediatric) Coronary Artery Disease (CAD) Hypertension (high blood pressure Cerebrovascular disease/stroke Hyperlipidemia (high cholesterol) Pulmonary Cluster Asthma (adult and pediatric) Chronic Obstructive Pulmonary Disease (COPD) Orthopedic/Rheumatologic Cluster Osteoporosis Rheumatoid arthritis Osteoarthritis (OA) GI Cluster Gastro Esophageal Reflux Disease (GERD) Peptic Ulcer Disease Inflammatory Bowel Disease (Crohn s Disease and Ulcerative Colitis) Chronic Hepatitis Neuro-Geriatric Cluster Geriatrics Migraines Seizure Disorders Parkinsonism Oncology Cancer (General) Breast Cancer Lung Cancer Lymphoma/Leukemia Prostate Cancer Colorectal Cancer Other Chronic Kidney Disease End Stage Renal Disease Hypercoagulable state (blood clots) Sickle Cell Disease (adult and pediatric) Cystic Fibrosis Weight Management Low Back Pain HIV Aetna

8 Aetna s QTC Strategy - Provider Collaborations High Performance Provider Initiative (HPPI) NATIONAL HPPIs U.S. Oncology ACC/Efficient Cardiologists Society of Thoracic Surgeons AK West Sutter / Palo Alto Medical Center San Francisco Bay area Cedar s Sinai Los Angeles Virginia Mason Medical Center - Seattle REGIONAL HPPIs HI CA OR WA NV ID North Central Advocate Health Partners and American Society of Clinical Oncologists - Chicago Management Network Services (MNS) Ohio AZ UT MT WY NM CO ND SD NE TX KS Southwest St. Luke s Hospital and TX Children s Hospital - Houston OK MN IA MO WI AR LA Northeast Partners in Care - NNJ MaineHealth Maine Mid-Atlantic Crozer Keystone Health System and Doylestown Hospital Philadelphia IL MS IN MI TN KY OH AL WV GA SC PA MD DE VA NC FL Southeast Kid s Health First Atlanta BayCare Tampa Vanderbilt Univ. Med. Center Nashville ME VT NH NY MA CTRI NJ

9 Engagement is the Key to Success. To meet our long-standing goals of improving the quality of health care and reducing medical costs, we re integrating: Health information technology (HIT) HIT Strategy: The Broader View Industry Leading Assets Evidence-based medicine; and Financial incentives to SUPPORT BEHAVIOR CHANGE across the entire health care spectrum Aetna

10 Aetna s Engagement Levers How we engage individuals Aligned incentives Program integration Simplified member experience Physician collaboration Personalized outreach & support Transparency, tools, & targeted information The benefits of engagement A healthier, more productive workforce Lower total costs for employees and employers Employees who are satisfied with their benefits Aetna

11 Driving Member Behavior Change: Health Opportunity Index Joelle s Opportunity Index June 5, 2008 Joelle s Goal!! Lifestyle Improvements Points Complete Health Risk Assessment Talk to Your Doctor About Stress General Health Points Complete Mammography Exam Sign up for Healthy Lifestyle Nutrition Program Diabetes Management Points Sign up for Disease Management Program Complete Diabetes Eye Exam Complete Diabetes Foot Exam June 5, 2008 May 20, 2008 You re at 40%! Congratulations, Keep Up the Good Work Aetna

12 Accountability and Condition Management Yield 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% Communications Design Disincentive Value Based Design Book of Business Sustained Accountability 20.0% 10.0% 0.0% Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12 Chart depicts Nurse Engagement Yield Yield = Members Nurse Engaged / Members contacted Aetna

13 Sample Plan Sponsor Three Year Plan Year 1 (2010) Incentivize Completion of Health Assessment Year 2 (2011) Get Active Campaign Year 3 (2012) Continue Get Active Campaign/Incentives tied to HOI Know Your Numbers for >30 year old associates Tie Incentives to Health Opportunity Index (HOI) Score Know Your Numbers and HRA completion campaigns extend to Spouses Communication Campaign Emphasizing Health and Wellness as a Corporate Responsibility Plan design creating HRA/HSA options Introduction of Plan Sponsor Population Health Scorecard Employee Annual Performance Scorecard now tied to HOI Score Plan design shifts to higher deductibles that can be offset by achieving maximal incentives Communications Campaign Emphasizing Use of High Quality/Cost Effective Providers via use of Transparency Tools and IOQs Plan Design continues to evolve to reward appropriate wellness and health care choices through use of incentives Aetna

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