Former Aetna Chairman and CEO Mark Bertolini Discusses Reimbursement and Digital Health

I’m really excited to share our latest video from our Digital Health C-Suite Series.

I recently had the opportunity to sit down with Mark Bertolini, Former Chairman and Chief Executive Officer, Aetna Inc. and a Board Director at Verizon Communications Inc. and Massachusetts Mutual Life Insurance Company.

During our discussion, Mark shared his thoughts on how to make healthcare more affordable and efficient for patients, the true status of value-based reimbursement, and how COVID-19 is shaking up the way we deliver care in the United States.

“The average American spends 20 hours a year in the healthcare system. That’s .4% of their waking hours. That means 99.6% of the time, they’re in the world, in their zip code, doing all sorts of things that impact their health far more dramatically than what the physician does when they see them… yet we have no view of that.”

Mark Bertolini, Former Chairman and CEO, Aetna

Mark Bertolini is a national health care thought leader. Mark assumed the role of CEO of Aetna in 2010, and of Chairman in 2011. He stepped down as Chairman and CEO and became a Director of CVS Health Corporation on November 29, 2018, upon completion of CVS Health’s acquisition of Aetna valued at $69 billion. Throughout Mr. Bertolini’s tenure at Aetna, he led the company’s transition from a traditional health insurance company to a consumer-oriented health care company focused on delivering holistic, integrated care in local communities.

Before joining Aetna, Mr. Bertolini held executive positions at Cigna, NYLCare Health Plans, and SelectCare, Inc., where he was President and Chief Executive Officer. Mr. Bertolini serves as a director of Verizon Communications Inc. (communications and technology solutions), Massachusetts Mutual Life Insurance Company (insurance and investment products), Thrive Global (sustainable, science-based solutions to enhance well-being, performance and purpose), and the FIDELCO Guide Dog Foundation (non-profit organization that breeds, trains and places German Shepherd guide dogs with people who have visual disabilities).

Status of value-based reimbursement

Having served as CEO at one the largest insurance providers in the United States, one of the topics we spent a lot of time discussing was reimbursement. In digital health, we’ve heard executives tout the promises of value-based care for decades but haven’t yet seen a full transition from fee-for-service to value-based or outcomes-based contracting. Mark had interesting insights here:

“Our whole journey to value-based provider contracts is lost. We’re wandering in the wilderness. If you’ve seen one value-based provider contract, you’ve seen one. They have all sorts of flavors. A lot of them don’t have enough meat in them to change behavior.”

COVID-19 will have a lasting effect on our healthcare system

Mark describes COVID-19 as an action-forcing event, causing healthcare to be more personalized and convenient.

“So many physician practices thought that digital telehealth was a fool’s errand… I was talking to one practice in a Zoom call and they went from 0 to 650 telehealth visits in a month.”

You can listen to our full conversation here (~14 minute video) and the full Digital Health C-Suite Series Playlist can be found here.

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