Health Care Reform: The Journey Continues

Health Care Reform – The Call to Action (5:41)


Beth Kenworthy:  Thank you. Good afternoon. This is Beth Kenworthy from Aetna’s Health Care Reform Project Management Office. Thank you for joining us today. In 2014, we will experience tremendous change as many of the Affordable Care Act’s biggest provisions go into effect.

To help you understand what’s on the horizon, we are pleased to bring you this webinar – Health Care Reform - What’s Next. During the next 50 minutes, Jay Sheehy, Chief Underwriting Officer and head of Aetna’s Health Care Reform Project Management Office will provide an update on the Affordable Care Act and how to prepare for and be compliant with 2014 ACA changes.

Due to the high demand for this webinar, we are unable to share the presentation during the call. Instead a copy of the presentation was emailed to you this morning around 9 am. Please hold your questions until the end of the presentation when the operator will open up the lines.

The Affordable Care Act impacts all of us. We’re excited to share our knowledge about what 2014 will bring and how the health insurance landscape is evolving. I will now turn the presentation over to Jay Sheehy.

Jay Sheehy:  Thanks Beth, and hello everyone. Thank you for taking time out of your busy schedules to join us for this webinar. We put together quite a bit of information for you, so I’m going to move through it pretty briskly, highlighting the key points that we want to articulate and feel would be of interest to all of you. And then, as Beth said, we’ll entertain as many questions as we can at the end of the formal comments.

So moving to Slide 2 with the Aetna Way, during this tremendous time of change, having the values that we hold ourselves accountable to for all of you and all those who we serve – integrity, excellence, caring and inspiration – is even more critical in these times of change; and personally I haven’t seen a more dramatic period for our industry ever before. Previously, back in the 80s when I was a young associate at Prudential, you know, we had the HMO Act, and we all thought that was a really momentous swing at the time. But even that pales in comparison to what we are all dealing with on a daily basis.

So why are we doing this? If you look at Slide 3 there are 49 million Americans that have lacked health care coverage in 2010. The total spend for health care in the United States is $2.6 trillion, and we project that to reach $4.8 trillion by 2020. And just looking at those numbers and the financial pressures that employers and individuals are facing is one of the driving reasons behind health care reform.

We also have over 20 percent of individuals who chose not to buy health insurance saying it cost too much. And 58 percent of Americans reported delaying or foregoing medical care in 2011, which is a very concerning statement and outcome when you know getting the appropriate, quality care at the right time and the right venue actually is far more cost effective in driving down health care costs and maintaining or improving the health of the individual.

So that’s why we’re here, and Aetna is very supportive of health care reform. We’ve been on this journey with all of you for over 10 years now. What we’re really trying to continue to address is the affordability and the quality aspects. A lot of what we’re looking at now with current regulations and where they are focuses on the access part, but there’s still a lot of work for all of us to do with affordability and overall quality of health care.

In moving to Slide 4 you can see, you know, that impact and the strain that this is putting on both the consumers and employers as they look at what percentage health care premiums represent.

On Slide 5 you sort of look at what waste there is in the system. And if you take the $750 billion our Chairman Mark Bertolini has often cited that if we’re able to redeploy that we would significantly buy down our national deficit in just 8 to 10 years; just by redeploying what we feel is waste, fraud, or inappropriate care in the system. So again, there is such great potential here for a solution by using the available monies already in the system.