Bertolini Kicks Off HIMSS14 With Message of Reform

In his opening keynote address at the 2014 HIMSS Conference in Orlando, Aetna CEO Mark Bertolini told the crowd that America's unsustainable healthcare system must change and reform, and that IT was going to enable this transformation. 

In his speech, Bertolini pointed to three particular strategies that would alleviate these costs and improve the quality of care. Those strategies include payment reform, talking care of the chronically ill better, and investing in wellness for the next 25-30 years. 

"We have to align the economic incentives from quantity to quality. We have to enable the consumer to interact with the healthcare system in a way that is simple and allows them to stay ahead. This is new model. This is the only model that works," Bertolini said.

On the topic of aligned incentives, Bertolini pointed to the decision in the 1980s to shift diagnosis-related group (DRG)-based payments as an example where this came into play. In that case, DRGs meant longer hospital stays didn't necessarily mean bigger revenues. It meant healthcare organizations had to think more about the way they cared for patients.

"We have to do what we did in 1983 with DRGs for everything," Bertolini said. 

Information technology, Bertolini said later, will enable improved access to care, engage the consumer, and allow the industry to invest in wellness for the long-term. He pointed to several at Aetna that are doing just that, including the company's well-known iTriage app.  

Bertolini, the CEO and Chairman at Aetna since 2011, started off his speech discussing the wastes that are present in today's healthcare system. He noted the system was created in the 1940s, and that line of thinking can't be used for today's problems. Approximately $800 billion is wasted in healthcare each year, he said, and healthcare is approximately 17 percent of the current gross domestic product (GDP).

"It can't keep increasing, we can't afford it," Bertolini told the crowd. Similarly, he noted, premiums are increasing at an unviable rate and soon the consumer will be paying more than half per dollar. He later challenged the healthcare industry to cut waste in half by the end of the decade.