Aetna Ceo Mark Bertolini是医疗保健先生

Aetna chief executive Mark Bertolini got his start in the health care industry in the late ’70s as an emergency medical technician in his native Detroit. He spent four years as a department coordinator in one of the city’s trauma center emergency rooms while earning an undergraduate degree in business administration and finance from Wayne State University. When he decamped for Cornell University in 1982 to get an MBA, he swore never to return to what he considered to be a broken industry. Today the 59-year-old says his early dissatisfaction resulted from the fact that he wasn’t in a position to do anything about the U.S.’s troubled health care system.

不再是。As CEO of Hartford, Connecticut–based Aetna, Bertolini is responsible for the health care coverage for 24 million Americans, a number that would grow to 33 million if the company’s recently announced deal to buy Louisville, Kentucky–based rival Humana for $34.1 billion in cash and stock is approved. After the deal closes, which Aetna management expects will happen as soon as the second half of next year, the company would be the U.S.’s second-largest health insurance provider by revenue, with $115 billion in annual sales, behind only UnitedHealth Group.

Post-merger, 56 percent of Aetna’s revenue will come from its government-related business — an attractive segment as the number of baby boomers aging into Medicare grows. But even as opportunities tied to Medicare continue to expand, the Affordable Care Act is pressuring insurers’ margins. “The regulations that are embedded in the law are regulating the profitability of the industry in a stringent manner — much more so than they ever have before,” says Ana Gupte, a health care analyst at Boston-based investment bank Leerink Partners. “Here you have this huge revenue opportunity [in Medicare], but you have to be much better at adding value if the price points are being contained as a result of all this regulation.”

Bertolini表示，将人类和Aetna一起携带，让他这样做。他预计该公司于2018年开始节省12.25亿美元的成本协同效应，并将其较低的双数百分比占据每年的营业收益。

Bertolini于2003年由Then-Ceo John Rowe招募到Aetna，以修复其药房，行为健康和牙科企业，并在2010年提升到顶部地点，也宣称这一交易潜力为消费者降低医疗费用。这将变得越来越重要，因为个人前往在线市场，以比较ACA后的保险计划。6月，最高法院维护了向购买联邦交流的个人支付的补贴合法性。

While he’s at it, Bertolini figures he may as well also fix the problem of the shrinking middle class. In January, he announced plans to raise Aetna’s minimum wage to $16 an hour, a 33 percent increase for the company’s lowest-paid employees. He cites several motivations for the move: For one, he projects that the $26 million cost could help save the company about $120 million annually on rehiring and retraining workers. But he’s also indicated that a broader, macroeconomic perspective had plenty to do with the decision.

“If we’re going to reinvigorate the economy, we have to restore the middle class,” Bertolini says. “There’s just been this question of, ‘Who wanted to try it first?’ It was sort of like, ‘Let Mikey try it.’ So I said, ‘I’ll do it.’” Aetna’s stock price was up nearly 40 percent from the January 12 announcement leading up to the人类收购的新闻。

“Mark is unlike any other CEO I’ve ever covered,” says Barclays health care analystJoshua Raskin。“一个原因是他的前视。他每天担心医疗保健的未来。我认为马克认为他的工作只是为了增加股东的收益;我认为他认为这也是提高首席执行官套件的完整性以及改善医疗保健系统的交付。“

亚博赞助欧冠撰稿人Katie Gilbert最近与Bertolini谈过了Bertolini，了解他改善美国医疗保健系统的愿景。

亚博赞助欧冠机构投资者：你说美国的医疗保健系统被打破了。你是什​​么意思？

In most every other facet of our economy, we talk about investments we want to make, and we talk about how we’ll finance them. In health care, we smash the two of those together. The financing is really the insurance. The investment is really, What do we do when we spend the money that is created by the financing? In the U.S. health care system, we’ve confused these two concepts, and we attribute the cost of financing to all of the ills of health care. And so insurance, because it puts the final price out to the market, becomes the bad guy in all of this, even though its margins are the lowest across the whole health care industry. You have large hospital systems that are getting 10 percent margins; you’ve got device manufacturers and drug companies getting 20, 25 and 30 percent margins. The insurance part of it is like 5 percent.

What we need to do is deconstruct the system and say, “Whether or not we want a single payer system or we want a private insurance system or we want an out-of-pocket system, let’s take the financing decision and set that aside.” Let’s ask, How should we spend our money, and what do we consider to be a good return on that investment?

经济实惠的护理法案如何推动医疗保健系统的改进？

经济实惠的护理法案所做的是创建一个迫使动作迫使事件，这些事件害怕系统中足够的演员，以具有从根本上不同的谈话。如果我们要设计[系统]结束，我会建议我们使用富有成效的人的最佳结果的定义设计。如果我们不断投资我们照顾的人的生活质量，那么我们将提高生产力。如果我们提高生产力，我们将提高经济可行性。如果我们提高他们的经济可行性，他们将更快乐。这应该是医疗保健系统的好结果的定义 - 而不是没有疾病，这就是它的设计方式。

艾特纳如何从正在谈论的变化中获利？

它改变了我们对管理风险的看法。这就是保险公司所做的;我们管理风险。在过去，我们试图创建个人的平衡风险池，这是我们可以在市场上的市场中提出价格的大量人口。正是在那种情况下，随着时间的推移利润，来自管理风险的利润，这一游泳池的增长和稳定性就足以加入了促进了未来的增长。我谈论的模型在它的头上变成了那个旧的，并说，我们应该接受事件;我们应该接受他们所在的人。病人生病了;我们应该尽力保持良好。我们应该尝试管理严重程度而不是尝试管理事件。

In that case, the underwriting model is being paid appropriately for the risk you’re assuming, and because you’re getting paid to manage that risk, you actually work on the severity and improve the underlying quality, and in that underlying quality and outcome management, there is the margin. You’re getting rewarded for improving the productivity, economic viability and happiness of the people you’re taking care of.

您预测了卫生保险公司的死以及政府的兴起作为卫生保健的力量。这对艾特纳的意思是什么？

经济实惠的护理法案破裂打开黑匣子承保和保险。每当您暴露规则和运行的方式时，您都会倾向于向商品化迈出。There are two ways to deal with commoditization: One is you put your thumb in your mouth, get in a fetal position, get in a corner and hope it all goes away — cut costs, cut costs, cut costs and hope you’re the last one standing.

或者您可以从价值链中抵消并说：“那个价值链已被商品化中断。我们做的事情是有价值的，我们可以在一个实际创造机会的新价值链中使用？“

对我们来说，它真的与我们的合作伙伴在提供商系统中搞并说，我们可以在同一基础上汇总所有的经济模式。今天在系统中，医生以现金为基础，医院担任收益，保险公司以保证金为基础。这些是医疗保健系统中的三个关键演员。这三种经济模式根本不合适。如果您可以通过说，让我们为我们假设的风险获得报酬，让我们照顾人们并照顾他们生活的质量;然后我们需要推动我们的提供商合作伙伴的方式，与棍子站在他们身上，并表示我们是保险公司，我们支付账单，这就是你将如何做到这一点。

这是如何转化为您所做的业务的变化？

We said to the hospital systems, Why don’t we partner? You get into our old business. Why don’t you manage the risk because you’re taking care of the patients? So you should get rewarded for doing that. What we become is less of a go-between, and we become a facilitator of the relationship between the provider and the patient.

你什么时候开始考虑收购人类的？

当我接管时，而不是有关响应上市的收购的机会，我们期待着我们的策略：我们希望作为我们投资组合的一部分？最终，我们希望在政府空间方面更大，因为政府正在为医疗保健支付越来越多。人类永远是我们思想的资产。总有谈话：现在是时候了吗？我们应该考虑一下吗？坦率地说，是的，直到3月28日，当我坐在[Humana Ceo] Bruce [Broussard]并与他谈论他是否准备好了。他说是的，这就是开始谈话的原因。

You’ve said that this deal will lower health care costs for consumers, though in the past consolidation in your industry has had the opposite effect. What makes things different this time?

因为付款模式和经济模式必须在当地市场发生变化。如果我们刚刚将这两个组织共同努力，服务费不持有存在，我们对当地市场的影响没有影响，那么它不会挽救消费者的成本。它真的是通过分享我们的知识产权和技术提供商，专注于人口健康的知识产权和技术在当地市场上创造了在当地市场的基本不同的经济模式。这必须是为了使这项工作发生，两家公司都致力于该战略。

投资者对筹集最低工资的决定是什么？有没有任何一个反对者？

实际上，在投资者社区中，我们没有将一个计数器发出一个反击。我们以一种非常重要的方式解释了它：我们说，这种医疗保健市场正在向零售市场移动更多。零售市场需要一个人的前线，以非常不同的方式照顾我们的客户而不是过去。如果我可以消除他们对能够为家庭提供医疗保健并在桌面上放面包的担忧，我可以与这些员工建立关系，让他们专注于我的客户并对他们同理心。我称之为我们的客户服务质量的基础设施投资。

你惊讶的是至少有一点推动力吗？

发生的有趣的事情之一是市场上有很多CEO - 你从拉里福克斯听到了它黑石还有一些其他人 - 这一直在说这一点，这是这个短期ism，这个零和游戏，不起作用。如果我们要重振经济，我们必须恢复中产阶级。

我们永远无法摆脱我们的经济的复杂性omy, but what we can do is reduce the complication of how we work with one another. If we think about that within the context of taking care of each other, I think that has a lot of resonance. It’s worked for us, and it’s working for other companies, and I have a feeling that we’ve crossed a Rubicon here from the standpoint of how we think about the leading companies.

您是否希望在主要的美国公司中开始趋势，以提高最低工资？

是的，我是，是的，它发生了。•

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