Main Problems
Excessive patient-centricity of the insurance company might lead to increased expenses. Under the scope of its brand-new Aetna Community Care initiative, Aetna is considering enhancing its presence in regional communities. The company will hire one hundred fifteen clinicians just for the state of Florida. However, as seen from the provided example, one of their members, an asthmatic 75-year-old, visited the ER 405 times in a calendar year, which amounted to more than one visit each day and cost the healthcare system $2.7 million (Henderson et al., 2018). In this sense, Aetna might either not benefit from healthier patients or experience increased expenses due to excessive presence.
Aetna works on several projects simultaneously, which constitutes most of their strategy and might be costly, considering that there are no guaranteed results. The objective of Aetna was to create a digital platform that could assist its customers throughout all of their operations with the business. A sizable budget would then back the digital platform for data analytics and behavioral science. In this sense, the issue is that there are no guarantees that applied behavior models will work and there will be a return on investment.
Solutions to Main Problems
Increasing the number of facilities nationwide, hiring more clinicians, and working on digital platforms simultaneously might damage the financial health of the company, considering that they have been seeking partnerships. The first solution to the problem is to reduce the costs of digitalization and behavior analytics models and concentrate available funds on the regional presence of Aetna. In this sense, there will be a hedge against the risk of failure in the IT initiatives. Such an approach will enable the insurance company to seek the conventional way of spreading its message and gaining presence. The second solution to the problem is to do the opposite and concentrate on building the brand image and primary strategy, which involves behavior analysis and a digital platform. Such a method can help Aetna revolutionize the market while helping more customer reduce their spending on healthcare and making medical care more accessible and convenient.
Recommended Solution
Considering that Aetna promotes health and has the desire to help patients reduce issues and make healthcare more accessible, comprehensive, and easy, it is rational to focus on the implementation of digital platforms and behavioral data analytics. The platform will help patients gain insights regarding complicated insurance topics. The given projects will still contribute to the growth of the company in several ways. First, the projects will contribute to the strong presence of the company, giving it a competitive edge due to the revolutionizing platform. Second, more individuals will be using the platform due to its inclusivity since the platform will aim not only to enlighten people regarding healthcare services but also remind them about their prescription intake. Considering that in case of unpredictable circumstances, such as a pandemic, the offline presence of companies will undergo challenges, digitalization of business seems like the best option. The company can additionally raise funds through investments from institutions or grants.
Outcome Expectation
The outcome expectations include the increased number of patients who will use digitalized platforms. Aetna’s revenue will increase due to an increased number of users. Furthermore, the company will take the leading role in the digitalized healthcare market. While contributing to more accessible healthcare and promoting affordable treatment, the firm will still have patients even if there will be healthier individuals with less need for medical services. Expansion of business will allow Aetna to diversify its service portfolio.
Reference
Henderson, R. M., Russell E., and Matthew P. (2018). Aetna and the transformation of health care. Harvard Business School Case 318-048. Web.