Aetna Story 2017 LogoAetna Story 2017

Building a Healthier You!

A healthier you is achievable when your health care plan
becomes a trusted partner on your journey toward better health.

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Building a Healthier You!

We’re building a healthier world by innovating to make health care simpler, easier and more convenient. We’re helping people achieve their best health, however they define it.

Innovation To make health care simpler,
more accessible, and convenient.

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Our people, our ability to innovate as a company, and our focus across the organization are helping to move us closer to our goal of building a healthier world, community by community.

Dr. Hal Paz, Chief Medical Officer, Aetna

Personalizing Carefor the Chronically Ill

Harold Paz, Aetna’s Chief Medical Officer
Doctor consulting patients
What percentage of Americans over 65 years of age use wearables to track fitness or vitals?

What percentage of Americans over 65 years of age use wearables to track fitness or vitals?

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People suffering with chronic conditions face unique and difficult challenges when it comes to maintaining their health and managing health care costs. A new patient-centered Aetna program offers them a more promising way to achieve both.

AetnaCareSM takes a forward-thinking, customized approach to treating members with chronic conditions by developing a personalized care plan, or care map, and providing access to a range of clinical and non-clinical resources that fits their needs.

The program gives members enhanced tools and resources that empower them to better understand their health and chronic conditions. It also employs more effective ways to engage individuals in managing their own care. More complex member engagements are done in person. The timing of these in-person engagements is determined by key moments or events, such as discharge from a hospital.

“With AetnaCare, we’re answering member demand for a user-friendly, personalized health care experience,” says Dr. Harold Paz, Aetna’s chief medical officer. “We’re also helping members at highest risk for medical complications improve the quality of their health. We offer them access to an entire ecosystem of health services that includes a checklist of evidence-based activities to round out their care.”

A care map is built around three primary objectives:

  • Promoting treatment adherence.
  • Ensuring that critical support needs are met.
  • Reinforcing healthy behaviors.

A nurse connects members to all the different resources that are needed, such as nutrition counseling or behavioral health services.

The program was launched in 2017 for members with diabetes and hypertension in Aetna’s accountable care organizations (ACOs).

“This is fundamentally a better way to engage with our at-risk members,” says Paz. “We build off patient trust in the health care system by collaborating with primary care physicians. If the doctor calls, people are more likely to take the call and listen. Integrating all of these services into a coherent and collaborative plan with the physician’s input gives the member the kind of convenience and simplicity needed to make access and compliance easy.”

Dave Hildebrand, Network Product and Telemedicine Strategies

Digital HealthSimplifying the Health Care Experience
to Improve Health, Reduce Costs

Gary Loveman, President of Consumer Health Services
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At Aetna, we are connecting members to a growing number of digital tools and services that are making their health care journey simpler and easier to navigate.

“We are building a digital platform that easily connects members to the whole package of resources to help them understand their health and take the best quality care of themselves,” says Gary Loveman, president of Consumer Health and Services. “We are developing simple, intuitive tools that provide a seamless experience while helping members achieve their health ambitions.”

ActiveHealth Management, part of Aetna Consumer Health and Services, helps members achieve their health care goals through health and wellness programs, care management services and targeted analytics. In 2016, ActiveHealth launched a member-centric “health event” initiative that connects with diabetic members at key moments in their health care journey.

15 million people used telemedicine in 2015,
up 50% from 2013

ActiveHealth’s program is designed to connect diabetes patients with key information when they really need the support most, like at diagnosis, when they’ve received new test results, or when they are admitted to the hospital. Targeted content and digital coaching, delivered via smartphone or computer, are key features of the online program.

For many members looking for flexible access to health care services, telemedicine is the right solution. Using a computer or smartphone apps, members can talk with health care professionals face-to-face in real time in high definition video. They also can send photos of wounds to health care professionals, for example, providing physicians with helpful detail in just seconds.

Aetna’s online tools and services help members decide when telemedicine is appropriate for treating their medical conditions. They also have the ability to compare prices for health care services provided through telemedicine, a local doctor’s office, or a local clinic. That means more options, more flexibility.

“Telemedicine is convenient, it provides members better access to health care, and it saves our customers money versus unnecessary access to emergency room services, for example,” says David Hildebrand, Aetna's head of Network Product and Telemedicine Strategies.

Adding to an end-to-end member-centric health care experience, Aetna’s bswift® platform helps people more easily navigate the benefits enrollment process by making it more member friendly—and more like a retail shopping experience. Bswift’s platform offers personalized, built-in employee decision support during enrollment. And the popularity of decision-support tools is exploding.

“Our goal is to join each of our members on their health care journey with a digital experience that is simple and easy,” says Loveman. “To do that, we have to deliver the tools and end-to-end capabilities our members are searching for, and the experience has to be personal to them.”

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Population HealthDriving local and population health

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Being the trusted partner for doctors and health care systems, we’re changing how people interact with the system to make it easier to navigate and keeping the focus on quality outcomes.

Dr. Sunil Budhrani, Chief Medical Officer, Innovation Health

InnovationIs Transforming Health Care

Dan Finke, Senior Vice President, Aetna Network & Clinical Services
Dan Finke presenting
Nationally, how many Americans were covered by accountable care arrangements in 2016?

Nationally, how many Americans were covered by accountable care arrangements in 2016?

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When Aetna and Inova formed Innovation Health in 2013, we set out to demonstrate that a health insurance company and a health care system, working together, could dramatically improve the quality and delivery of patient care. Today, Innovation Health’s measurable results reveal that health care transformation is well underway.

The Innovation Health approach already is producing 21 percent fewer 30-day re-admissions and a 15 percent decrease in costs.

“Innovation Health combines the strengths of both a health plan and health system. We joined forces to reimagine and transform the way care is delivered locally in the community,” says Dan Finke, senior vice president, Aetna Network and Clinical Services. “It’s a journey, and we’re making a meaningful difference as we go. We’ve been very excited to discover how aligned we are, which allows us to quickly work through issues. We’re focused squarely on the member experience and quality of care. That focus is empowering us to improve care delivery, cost, and overall individual member health.”

21% decrease in 30-day re-admissions

Providing health care solutions for Northern Virginia, Innovation Health is part of the growing value-based care trend — paying for quality of care and outcomes rather than quantity. Joint ventures like Innovation Health are proving their value through consistent, measurable results.

Value-based care also means more efficient and effective coordination between the insurer and the provider to benefit the member. A nurse concierge, for example, can work with physicians to find low-cost alternatives for members with unnecessarily expensive medications. Better coordination makes higher quality, more affordable care possible.

“When we talk with our members and their employers about Innovation Health, we can see the light bulb go on,” says Dr. Sunil Budhrani, Innovation Health’s chief medical officer.

“They get a whole team centered on helping them and supporting them in their journey to health. We sometimes send team members to people’s homes if, for example, a member is diabetic and their blood sugars are trending very high. We’re able to see what our members are experiencing firsthand, in a way that no other insurance model can do. There really hasn’t been a model like this.”

Alan Roberts, Aetna/Coventry Brand Ambassador

Aetna MedicareSets the Standard

Alan Roberts, head of Aetna Medicare Star Ratings
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If you’re looking for a high-quality Medicare Advantage (MA) plan, there’s no better signpost for your journey than the Centers for Medicare & Medicaid Services (CMS) Medicare Five-Star Quality Rating System. Ratings are based on strict quality measures, and Aetna/Coventry is among the MA providers leading the way.

Aetna Medicare Advantage once again earned high overall star ratings for 2017, building on strong results in years past. For 2017, 93 percent of Aetna Medicare members are enrolled in plans rated four, out of five, stars or higher—an increase of 6 percent from the previous year. Aetna has the highest percentage of Medicare members enrolled in plans rated four or more overall stars among publicly traded companies.*

Star ratings measure MA plans against five individual performance criteria:

  • Staying healthy.
  • Managing chronic (long-term) conditions.
  • Member experience with the health plan.
  • Member complaints.
  • Health plan customer service.

MA prescription drug plans are rated on individual performance measures that include:

  • Drug plan customer service.
  • Member complaints.
  • Member experience with the drug plan.
  • Drug safety.

“When it comes to the Medicare population, the star ratings are the most objective measure out there of the progress we’ve made toward our goal of building a healthier world,” says Alan Roberts, head of Aetna Medicare Star Ratings. “We’re achieving a level of quality that members can really feel, be it when they are using our products, engaged with our customer service team, or working on a personalized care plan with an Aetna case manager.”

Aetna’s high star ratings come from a strong commitment to improving health outcomes and simplifying the health care marketplace and experience for our members. For example, Aetna has built into its contracts clinical data goals to drive the use of tools that help providers seize real-time urgent care opportunities. Also, clinical programs are aligned to ensure that Aetna meets members where they are on their health care journey—to make more healthy days possible.

When it comes to customer service, it’s not about just answering questions. Aetna positions itself as a true advocate for members.

Robert Bristow, a retiree from Catawba, NC, talks to beneficiaries at health fairs about MA as a volunteer Aetna/Coventry Brand Ambassador, and he has seen Medicare star ratings come up often in the conversations.

“I think the ratings are very, very important to beneficiaries signing up for the first time and to the retention of existing members,” says Bristow. “Aetna certainly stands out in that respect.”

*Includes publicly traded companies with more than 250,000 MA enrollees.

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CommunitiesBuilding stronger, more connected
communities

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Investing in communities’ health initiatives, we’re working alongside communities in their journey to become healthier places and enabling people to achieve their best health possible.

Joan Wright, National Chair, AetVets Employee Resource Group

Veterans’ CareHelping Heroes at Home

Joan Wright, a Director of Systems Support in AIS
Soldier coming home to family
A city that reduces car use by 10% and distance to public transportation by 30% reduces its heart disease rate by?

A city that reduces car use by 10% and distance to public transportation by 30% reduces its heart disease rate by?

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Veterans often face challenges in successfully transitioning from military service to their civilian career path, but Aetna is on a mission to change that.

Aetna built on its strong track record for hiring, developing and retaining top talent from the veterans and Guard-Reserve communities with new initiatives in 2016 that are bringing an increasing number of veterans to the company. The number of veterans and transitioning military personnel hired in 2016 increased 130 percent over the previous year.

130% increase in Veterans and Transitioning
Military Personnel Hired

“We believe it’s important that we create opportunities for veterans and their families to overcome the challenges they face returning to civilian life,” says Mark Whalls, head of Military and Veteran Recruiting at Aetna. “Helping veterans to lead healthy lives outside the military is a natural part of Aetna’s focus on building healthier communities.”

In 2016, Aetna:

  • Partnered with the Microsoft Systems and Software Academy, which helps active duty service members develop their IT career skills over 16 weeks. Those who successfully complete the training get a job interview at Microsoft or one of the participating partners, such as Aetna.
  • Created a mentoring program for veterans to help them develop their skills and work more effectively toward their goals.
  • Became the lead sponsor of America’s Parade—the New York City Veterans’ Day Parade—on November 11, 2016. Aetna had a float and a strong contingent of marchers in the parade.

“We owe a great debt to veterans and their families,” says Joan Wright, a director of Systems Support in Aetna Information Services and national chair of the AetVets employee resource group. “But make no mistake: Veterans make outstanding employees. They are ready for whatever comes their way.”

Signaling a deepened, sustained commitment to veterans and our nation’s military men and women, Aetna held a Reaffirmation Ceremony in Hartford in November. The event featured Aetna and community leader speakers, the signing of a formal commitment document, military color guard, local and regional media, and veteran employees.

Valerie Miranda, a customer service supervisor in San Antonio, is a 28-year veteran of the Army who saw three combat tours before landing her first civilian job with Aetna in 2015. Aetna’s concern for veterans and the support offered to veterans made her transition relatively easy.

“I was impressed by Aetna’s values and how well they know veterans,” says Valerie. “When I interviewed with the site manager, she said to me, ‘I can teach you about health care, but I can’t teach you how to be a leader.’ And when I was invited to attend the parade and see the Reaffirmation Ceremony in person, it just gave me chills. It made me feel really valued.”

“We’ve worked hard to be veterans’ company of choice. We think we’re on our way to getting there, and 2016 put an exclamation point on all that work,” says Whalls.

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Gabby Lilienthal, Talent Development Associate

Aetna Brings ReliefTo Students With Student Loan Debt

Kay Mooney, Vice President, Employee Benefits
Student studying

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New college graduates today start their working lives with more, and often crippling, student loan debt and greater financial worries than ever. In 2016, we set out to help. We expanded our social compact with employees with a new program that can help ease their student loan debt.

Aetna’s student loan repayment program matches employees’ student loan payments up to $2,000 annually, up to a lifetime maximum of $10,000 for qualifying loans. Employees who have earned undergraduate or graduate degrees from accredited institutions within three years of applying to the program are eligible.

More than 430,000 clock iconhours Volunteered by Aetna
Employees in 2016

“Employees are our most valuable asset. Our social compact programs help make them healthier, happier and more productive,” says Kay Mooney, vice president, Employee Benefits. “That, in turn, allows them to focus on what matters most—helping our members achieve their wellness goals. Investing in our employees’ health and well-being is a solid foundation for building a healthier world.”

Gabby Lilienthal, a talent development associate with Aetna Human Resources, graduated from the University of Connecticut in 2015 and has applied for assistance with her student loan debt. It’s already making a real difference.

“It expedites the rate at which I can pay off my loans and gives me a greater opportunity to work toward my future goals, like owning a house,” says Gabby. “I feel and understand our mission more clearly because I’m impacted by it first-hand. I want more than ever to deliver on that promise.”

The new student loan repayment program builds on Aetna’s existing Employee Tuition Assistance program, which makes available financial assistance to employees working toward a college degree or certification. It also builds on other aspects of the social compact Aetna announced in 2015, including a new minimum base hourly wage for U.S. employees of $16 an hour and an enhanced medical benefits program for eligible employees.

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Bloomberg’s The Year Ahead Summit: 2017

Message to Shareholdersfrom Chairman and CEO Mark T. Bertolini

Aetna delivered solid financial results while firmly advancing our mission of building a healthier world—one person, one family, and one community at a time.

In a rapidly evolving market, we grew total revenue by nearly five percent to $63 billion and generated net income of nearly $2.3 billion. We ended 2016 serving 23.1 million medical members in communities across the country.

Our performance was driven by multiple businesses, particularly our Government business, where Medicare membership grew nearly 13 percent and premiums grew year-over-year by 15 percent. For the third consecutive year, we increased the percentage of our Medicare Advantage members enrolled in plans rated 4 stars or higher, reaching 92 percent in 2016—the highest percentage among our publicly traded peers. These strong star ratings are a reflection of our commitment to improving quality of care and service, which keeps our members out of the hospital and in their homes and communities. Additionally, our Consumer Health and Services team is enhancing our care model to proactively engage members using real-time data paired with predictive analytics to improve health. We expect these improvements will provide members, including those facing chronic illness, with a simpler way to navigate through the health care system.

We also successfully advanced our strategy to help transform the health care system from volume-based payment models to care-based models that reward the quality and value provided to our members. At the end of 2016, over 45 percent of Aetna’s medical spend was running through a value-based care model, positioning us to achieve our goal of 75 percent by 2020. We also announced new joint-venture agreements with Banner Health in Arizona and Texas Health Resources, demonstrating our commitment to strong, collaborative relationships with leading providers across the country.

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Improving the health of communities across the nation is an important component of our mission. In 2016, the Aetna Foundation, in partnership with the American Public Health Association and the National Association of Counties, launched the Healthiest Cities and Counties Challenge. Over the next several years, the Foundation will work to identify and share best practices and proven innovations in communities across the country to improve the social determinants of health—including healthy behaviors, community safety and environmental exposures.

For the third consecutive year, we increased the percentage of our Medicare Advantage members enrolled in plans rated 4-stars or higher, reaching 92 percent in 2016—the highest percentage among our publicly-traded peers.

Following a thorough business review and in light of increasing losses, we decided to reduce our presence on the individual public exchanges established by the Affordable Care Act. For the full-year 2016, we reported $450 million in pre-tax losses in our individual ACA-compliant products. As the health care policy debate moves beyond the ACA, Aetna will be a positive voice for reforms that improve the quality and affordability of heath care for all Americans. Going forward, we will continue to advocate for policies that provide consumers with greater choice and flexibility to meet their health care needs while facilitating a sustainable marketplace for insurers, including Aetna, to serve the uninsured and underserved markets.

Although we could not get to a successful conclusion with our Humana acquisition, our strategy does not change. We will deploy our capital efficiently to deliver on our commitment to build a consumer-centered health care system that improves affordability, promotes quality, and provides a simpler user experience. Our vision is for every member to enjoy the healthiest life journey possible, and we are committed to helping them realize that goal.

Thank you for your continued support and investment in Aetna.

Mark T. Bertolini's signature

Mark T. BertoliniChairmain and CEOApril 7, 2017

Aetna at a GlanceInnovating to make health care simpler, more
accessible, and convenient

Our people, our ability to innovate as a company, and our focus across the organization are helping to move us closer to our goal of building a healthier world, community by community. Our strength as a company will help us achieve our goals faster and deliver greater value to consumers.

In 2016, Aetna generated strong revenue, providing significant momentum and a positive outlook for the company in 2017.

Aetna at a Glance:

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