- Aetna CEO Mark Bertolini said Thursday at the Washington Ideas Forum that healthcare reform in the U.S. should come from bipartisan proposals and should include efforts to focus on a person’s overall health rather than treating specific conditions.
- Bertolini said the Healthiest Cities and Counties Challenge the Aetna foundation helped launch last year is part of that framework, and is a way of “crowdsourcing social determinants of health.”
- Also at the forum Thursday, Sen. Mark Warner (D-Va.) said Congress could come to an agreement on stabilizing the Affordable Care Act (ACA) exchange market. “There’s a lot of common ground, we just need the runway to play that out. And I think it will happen,” he said.
Senate Republicans would have a hard time disagreeing with one of the sentiments Bertolini expressed about major changes to the healthcare system: “When it’s not bipartisan, that’s when things blow up.” He added that he has heard there are currently across-the-aisle discussions about healthcare legislation, and that ACA repeal is definitely off the table for now.
He said there are simple, straightforward ways to fix the healthcare system, but they are muddied by politics. “Anything of major social import needs to be bipartisan,” he said. That also makes it possible to fix problems with laws and regulations down the road.
Congress is fixating on financing the system, but the real issues are in the system itself, Bertolini said. Providers and payers should be looking at more ways to prevent disease and improve treatments with social services and a more personalized approach to patients, he said.
“You have to go back to local,” he said. “You have to be in the communities and in the neighborhoods and talk about what works.”
Doctors rarely talk to their patients about their diet, exercise habits and mental health. And when they do, patients often feel the need to lie. “We need to liberalize the definition of benefits,” he said. It’s cheaper in the long run to pay for a patient’s transportation to the doctor’s office or to connect them with services like Meals on Wheels.
“We’ve got it wrong, and it’s showing up in our emergency rooms and it’s showing up in opioid addiction,” he said.
Bertolini said efforts like the Healthiest Cities and Counties Challenge will help. The program awards competing small and mid-sized cities, counties and tribes seed money to "develop practical, evidence-based strategies to improve measurable health outcomes and promote health and wellness, equity and social interaction."
It aligns with the broader overall movement toward value-based reimbursement models, which seek to connect providers with community resources that help patients stay healthy. These efforts can help people follow treatment plans, find more ways to exercise and cook nutritious meals. Providers can also ensure their patients have enough food and can access mental health and addiction treatment.