How 2 life-threatening events changed how Aetna's CEO views health care

Julia La Roche
Reporter

Two life-threatening medical challenges have shaped how Aetna (AET) CEO Mark Bertolini views the health care system and how he’s changing the approach to improving the patient experience.

In 2001, Bertolini’s son, Eric, then 16, was diagnosed with a rare and deadly form of lymphoma. Bertolini left his job at the time as an insurance exec at Cigna to be by his son’s hospital bed. Today, his son is the only known survivor of the disease. In 2004, a year after his son returned home, Bertolini suffered a spinal cord injury in a horrific skiing accident. He is partially disabled. He also donated one of his kidney’s to his son in 2007.

“The biggest message out of all of those for me was that the health care system fixes what’s broken,” Bertolini told Yahoo Finance. “So, for me, it was a broken neck and a macerated brachial plexus, bad nerve damage. For my son, it was his cancer. But when they were done with that work, thinking of me as a whole human being, engaging in my own life and being back in society in a way that was productive and useful for me was not on their agenda.”

What Bertolini learned was that the journey after leaving the hospital could be “very murky and difficult to navigate.”

Building programs beyond just paying for acute care

This experience led him and Aetna to take a more holistic approach to health care, pointing to the 1948 definition of health defined by the World Health Organization as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Mark Bertolini (Michael Nagle/Bloomberg)

“As I tried to put my life back together, as I tried to advocate for my son when he had his cancer, it became apparent to me that we have big holes in the health care system that we need to fill in some way and that we need to treat people as whole people. We need to make sure that they’re rehabilitated back to a life they enjoyed. And so we started building programs beyond just paying for acute care,” Bertolini said.

This approach involves looking at how people live their lives, where they reside, and if they’re able to be productive members of society.

“We redefined health as a healthy individual who is productive. A productive individual is socially, spiritually, economically, and physically viable and viable people are happy,” Bertolini said. “And so we should be making people happy because they’re productive members of society.”

Zip code, not genetic code

He pointed out that longevity, the length of one’s life, approximately 10% is related to clinical care, 30% is related to genetic code, and 60% is related to where one lives, meaning social determinants and lifestyle factors.

“Longevity is very much defined by your zip code, not your genetic code,” Bertolini said, “We have zip codes in this town, in New York, we have zip codes in Detroit, we have zip codes in Chicago where individuals in one zip code have fifteen to twenty years less life expectancy than people in the zip code next door.”

Aetna decided to get into the communities to understand the social determinants. The insurer started building programs ranging from urban farms to eliminate food deserts to yoga-mindfulness in inner city schools to help students focus on their studies.

In addition to these sorts of programs, technology is another factor that’s playing an increasing role in creating healthier communities.

One of the next big trends will be in-home monitoring through wearing devices. This will provide information where someone within the community can check in on their friends, family, and neighbors.

He compared it to logistics used by companies like UPS, FedEx, Amazon, Uber, Lyft, and Airbnb.

“They don’t own the means of production, meaning they don’t build the product. They don’t owe the customer other than to connect the customer to the product,” Bertolini said. “So if you think about that tool in health care, if we can get inside the home with monitoring, instead of knocking on the door and saying, ‘We’re here from Aetna. We’re here to help,’ if we can get information from that allows us to understand demand —what do they need in the way of help? — and source that in the local community, we can create economic viability in the community by having people in the community supporting people in the community in their homes.”


Julia La Roche is a finance reporter at Yahoo FinanceFollow her on Twitter.