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Tom Grote, CEBS President, North Capitol Market Aetna

Virginia Chamber of Commerce Health Care Conference JUNE 6,2013 Engaging consumers to purchase value. Tom Grote, CEBS President, North Capitol Market Aetna . What do people think about health care?... It’s no wonder members find it hard to engage.

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Tom Grote, CEBS President, North Capitol Market Aetna

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  1. Virginia Chamber of Commerce Health Care ConferenceJUNE 6,2013Engaging consumers to purchase value Tom Grote, CEBS President, North Capitol Market Aetna

  2. What do people think about health care?... It’s no wonder members find it hard to engage Source: 55 Gen X and Gen Y participants surveyed and asked what they think of with health insurance.

  3. Current situation for the average consumer of healthcare: • Providers are not financially rewarded for delivering value • Not knowledgeable about medical conditions • Not aware of appropriate levels of care for medical conditions • Lacks data about provider network and availability • No easy access to actionable information • Not empowered to make appropriate & cost effective healthcare decisions

  4. Catalyst for change A system focused on transactions is not optimal for patients or payers

  5. We Connect Providers and Patients with Powerful, Personal Technology Accountable Care Solutions HEALTH INFORMATION EXCHANGE HEALTH PLAN PRODUCTS AND SERVICES DISTRIBUTEDAPPLICATIONS CONSUMERENGAGEMENT CLINICAL DECISION SUPPORT & WORKFLOW MANAGEMENT MOBILE CONNECTIVITY

  6. Virginia Provider Collaborations

  7. Healthcare’s leading mobile platform to empower people to make better healthcare decisions, and improve healthcare delivery With iTriage, healthcare is on the go with a consumer. The iTriage app provides a Symptom-to-Provider pathway, connecting patients who are actively looking for healthcare with providers who have the capability and capacity to deliver that care iTriage can even help a consumer book an appointment with a physician or pre-register with an Emergency Department iTriage is a top 5 free Healthcare and Fitness app with a 4+ (out of 5) user star rating in the Android Marketplace and iTunes App Store iTriage – connecting consumers to information and care on the go

  8. Steerage:Non-Urgent / Inappropriate Use of ER • Member Decision Support • Educating members about conditions and where they can be treated. • Steering members to the preferred level of care • If a member selects Emergency Department for a condition that could be treated by a lower cost provider, that person is provided with additional information regarding cost and alternatives

  9. We are committed to driving health care transparency • Online cost tools help members to stop guessing and start knowing so that they can feel confident with the health care choices they make. These tools include: • Member Payment Estimator • Physician unit price tool • Medical procedure by facility cost tool • Price-A-DrugSM

  10. The power of health in members’ handsUnderstanding what to do is the first step MEMBER PAYMENT ESTIMATOR Offering important health information, however and wherever members need it, to help them make smart decisions The power to choose wisely • Average $170 Member savings for Members using Member Payment Estimator (MPE)* • Real-time cost estimates based on the member’s health insurance and benefits plan • Compares up to 10 in-network doctors, hospitals, or facilities at a time for over 550 services and procedures • 96% of members have access*

  11. The power of health in members’ handsQuick, confident action = smarter decisions The power to use the best care • Savings of 3-19% using an Institute of Quality (IOQ) for bariatric, cardiac, and/or orthopedic care* • Facility quality verified by IOQ designation* • Average 17% savings per episode of care through Aexcel providers* Giving members tools to help them at each step in the path of life and providing easy access, when they need it INSTITUTES OF QUALITY

  12. We engage members with the best tools and resources available. We meet them where they are and that leads to better health results. EDUCATION SUPPORT INSIGHT • Empower members to: • Understandwhat to do • Act quickly with confidence • Get help where they need it Successful engagement through equipping and encouraging members to put the power of health in their hands

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