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From Personal Pain, The Motivation For Business Innovation…. Aetna’s CEO Mark Bertolini, on remaking the healthcare system

on Tuesday, January 26, 2016
From Personal Pain, The Motivation For Business Innovation….
Aetna’s CEO Mark Bertolini, on remaking the healthcare system

I had the chance to connect with Mark Bertolini at the WOBI World Business Conference in New York City and get his insights on how he is driving change in the industry.
The conversation was published in two parts in the Knowledge@Wharton website. See Part I & Part II here.

Roopa: So I am here today with Mark Bertolini, the CEO of Aetna which is now poised to be the biggest healthcare company in the U.S..

Mark Bertolini: Well, it depends on -- yeah, but we'll be close.

Roopa: Well, you're close.

Bertolini: We'll be big.

Roopa: You will be very big.

Bertolini: We'll be a Fortune 20 and a FTSE 30 company. So yeah.

Roopa: Fantastic. It's a nice place to start from.

Bertolini: It is.

Roopa: So you've been called many thing including "Healthcare's Mr. Fix-it."

Bertolini: Sure.

Roopa: And how do wear that mantle given that you've been in this healthcare economy for a while now? You've seen it from your perspective in the trauma care center when you were working there and now you're a CEO. How is it evolving?

Bertolini: Yeah. Well, I think, you know, through all of my experiences, in a level one trauma center as an EMT, Emergency Department Coordinator and, working in the hospital industry, working in the early days of managed care back in the 80's and then my own personal experiences with my son and myself in the healthcare system -- I realized that it wasn't getting any better. And actually in the late 80's and early 90's I had a set of these acetates. Remember when we used to have overhead projectors with acetates?

Roopa: Right.

Bertolini: And I pulled them out and I was talking about the stuff back then and it's nice to see, you know, almost 25 years later we're finally getting around to it and I think the issue is that we define health the wrong way and it became incredibly apparently to me when my son battled with cancer for quite some time and when I had my ski injury where I broke my neck the system wanted to fix the medical issue but wasn't at all concerned about the individual they put back into society. And so for me it was my pain and my limitations, my physical limitations trying to get my life back which you never really do. For my son, you know, it was his whole journey for a year-and-a-half, two years with cancer and then, you know, I gave him a kidney in 2007. It was just this whole journey where they just wanted to get rid of the cancer and once the cancer was gone they were done with him.

Roopa: Right.

Bertolini: And so I came to this conclusion that were a whole lot of things wrong with that but probably the most important thing was -- what do we define as success? And success is really healthy individuals are productive, productive individuals are economically, culturally, socially and spiritually viable and viable people are happy. And if we can do that individual by individual and community by community we'd have a much better world. And so how do we a design a system around that is really the point, right?

Roopa: Right. And how does that change how you think of Aetna's products and services?

Bertolini: So one of the things -- when I put my son into hospice in July 2003, July of 2002 -- July 15, 2002 -- I had to admit he was going to die in six months and he couldn't get curative services anymore. And when I got out and he was home and he graduated from hospice and today, you know, he's 30 and a productive human being in society, I was working at Aetna and I went to -- I was working with Jack Rowe and I said to Jack, "You know, we should change the way our end of life care program works. And let's waive the requirement that you have to admit you're going to die and let's allow people to get curative services while they're in hospice." And when we did that, we did a study for two years with self-funded customers because we weren't sure what -- we weren't sure if it was going to be a run on the bank and what we found was that instead of 25 percent of the people dying at home, 75 percent of the people died at home and we saw an 89 percent reduction in inpatient bed days and we saw 75 percent reduction in costs. And the families and the feedback we got on the program was, "This is incredible."