1. What to Expect from Health Insurance in the Future
Dale Mackel
Market President
Coventry Health Care, an Aetna company

2. ACA Impact on Health Care Industry is Unprecedented
Providers
Practitioners
Brokers/Exchanges
Carriers
Disruption
Innovation
Transformation

3. Today’s Topics As a carrier, Coventry/Aetna will focus on:
Empowering the consumer
Innovating the Care Delivery System
Changing how insurance is packaged & purchased
Supporting ACA law evolution to preserve the goal of accessibility, affordability and sustainability

4. Empowering the Consumer
Shift from B2B to B2C. For the first time, the consumer will be an informed buyer of health care services
Enablers will be technology and transparency
Mobile platforms that facilitate symptom-to-service capability (Aetna’s iTriage app)
Powerful self-service tools that put more control into the hands of consumers
Price list for services at network providers (may even be variable based on supply & demand)
Consumers want more health, not more treatment

5. Care Delivery Innovation
Building new network models to drive quality, affordable care
ACO’s, HPN’s, Narrow Networks, Patient Centered Medical Homes
Primary care physician will navigate patient through the health care delivery system
Quality/Efficiency/Outcomes – how the delivery system will be measured and compensated
Networks customized for certain industries (hospitality)
Must be of value to the consumer
Goal is not to Pay Less for Care but to Pay for Less Care

6. How Insurance will be Purchased/Packaged
Public and private exchanges will influence purchasing dynamics
Exchanges are here to stay
Public exchanges will become more functional over time and proper for subsidy eligible consumers
Private exchanges will innovate & flourish
Offer exceptional on-line consumer buying experience (Amazon, Priceline)
Keep employers connected to employees from a benefits perspective
Customize insurance plan offerings based on individual circumstances

7. Supporting ACA Law Evolution
Restore consumer choice & relevancy for small companies & individuals
Essential Health Benefits are a good start, but benefit flexibility is required to strike a proper balance among coverage, cost and need (over-insured)
Rating Algorithm Enhancements
Incentives to attract young healthy population into the insurance pool
Consumer needs should drive changes in the law