Aetna – Reshaping Healthcare

Doctors and nurses taking care of the patients and connecting together: healthcare and technology concept

I just attended the Aetna National Broker Advisory Council Meeting. This is a very inspiring meeting to me, one in which I learn of the ways Aetna is helping to tackle the biggest issue in healthcare today: COST! While the CVS-Aetna merger is awaiting approval, it’s nice to hear that Aetna is moving forward with their… [Read More]

Message Heard – Pharmacy Costs are in the Spotlight

Rx Prescription #2

No doubt the health insurance carriers are getting the message: pharmacy costs are too high, and pricing is not transparent. UnitedHealthcare has announced that they will begin passing rebates directly to retail purchasers at the point of purchase. Pharmacy rebates – which are usually shared between the pharmacy benefits manager (PBM) and the health insurer… [Read More]

Take Politics Out of Healthcare

Medical politics and health reform challenges or universal healthcare system stress concept as a group of opposing ropes pulling on a doctor stethoscope as a medicine management symbol with 3D illustration elements.

Three additional states have joined California in an investigation of the third largest insurer in the United States – Aetna – alleging their medical director denied a $20,000-per-dose infusion, admitting in a deposition that he never looked at [the] patient’s medical records. The media and public have cried out that the insurer has put profits over patient… [Read More]

A Few Suggestions to Simplify Healthcare

Path or way from A to B - solution strategy concept

I keep waiting for Bezos-Buffet-Dimon to call me (I know they will one day) but in the meantime, cyberspace is a good place to share my thoughts on healthcare redesign. The front door to healthcare delivery should be an easy-to-use smartphone application which is pre-populated with a healthcare calendar, set up with you and your doctor, to remind you… [Read More]

Can You Believe What Happened to Me at the Pharmacy?

pharmacy counter with blur shelves of drug in the pharmacy drugstore background

This is going to be a rant blog. I happen to know that a lot of people from Aetna (which is my insurer) read this. But, it really doesn’t matter whether it’s Aetna or another medical insurer – they all have the same issues. Thankfully I am reasonably healthy. As with most people, my most frequent encounter with the… [Read More]

Healthcare Has Been Screaming for a Disruptor

businessman screaming news, or adult who asks a job - communication

Someone heard. Rumors have been swirling that Amazon, the market status quo killer, was setting its sights on healthcare – one of the least transparent and most inefficient markets – which accounts for almost 20% of U.S. Gross Domestic Product (GDP). Today Amazon joined with market-savvy Berkshire Hathaway and JPMorgan Chase to announce that a new… [Read More]

A Look at 2018 Healthcare Issues

Illustration of 2018 greeting for new year celebration with heartbeat design

Price Waterhouse’s Health Research Institute released their 2018 Top Health Industry Issues report. 2017 was quite a year for healthcare as the industry tried to address controlling healthcare costs in light of the failure of legislative reform along with natural disasters, opioid abuse and cyber security – and all of those issues continue. With the inability… [Read More]

Will the Urge to Merge Help Healthcare?

Businessmen connect puzzle lamp. Joint efforts, success, union, idea. Vector illustration Eps 10 file. Success Cooperation

The announcement this week that CVS would be acquiring Aetna is the latest effort to remake U.S. healthcare. Costs are still spiraling upwards at an unsustainable rate and try as we can, inertia makes efficiency and cost reduction battles difficult to win. “Bigger” hasn’t done much to reduce costs. The health insurance market is down to… [Read More]

Another Setback for Private Exchanges

Medical touch screen

Only three years ago, we were told that the future of healthcare had arrived. Mimicking employers’ transition of retirement plan treatment, employers were going to be freezing traditional benefit programs en masse and migrating their employees to a “defined contribution” private exchange model – a model where costs were fixed and employees bear the financial… [Read More]

The Great Debate: Cannon v. Gruber

The Great Debate: Cannon v. Gruber

Two weeks ago, I had the privilege of attending the 2015 Sun Life Wake Up Summit which featured a debate on ACA topics between two of the greatest intellectuals on the subject. Jonathan Gruber, one of the architects of the law, represented the pro-ACA position and Michael Cannon, a key driver behind the King v…. [Read More]