Aetna 2005 Annual Report Download - page 32

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28
Over the last several years, there has been a subtle but
very important shift in the role of health insurers. In the 1990s,
during the backlash against managed care, insurers were on the
defensive as they responded to criticism from physicians, patients
and elected officials; and faced increased regulatory restrictions.
More recently, health insurers are becoming active partners with
other participants in the health system in efforts to improve the
quality of care, manage increasing health care costs and help
reduce the large number of uninsured in this country.
Aetna is playing a leadership role in this new activism with major
programs in health care quality; disease management, including
most recently, depression; disparities in care for racial and ethnic
minorities; care at the end of life; and efforts to reduce
the number of uninsured. In this context, Aetna has advanced
innovative initiatives to improve accountability, and link
payment for care to quality and effectiveness. Such efforts,
which are generally referred to as value-based purchasing or pay
for performance, are becoming a major movement in the
American health care system – all designed to make sure we get
what we pay for in health care.
Concerns regarding health care cost and quality are the substrate
for the growing interest in pay for performance. Regarding cost,
the year-over-year increase in health care costs, which for 2005
was estimated at 7.4 percent, continues to significantly outpace
the growth of our overall economy, as measured by the Gross
Domestic Product.1While we undoubtedly receive significant
value for this investment, absent an unexpected surge in overall
economic growth, this overspending on health care soon will
cause Americans to forgo goods and services that they would
ordinarily use in order to purchase health care. In fact, for many
on limited incomes, this dreaded choice already is a daily reality.
The year-over-year
increase in health care
costs continues to
outpace the GDP.
Highest spending
often associated with
low-quality care.
GETTING WHAT WE PAY FOR IN HEALTH CARE
John W. Rowe, M.D.
Executive Chairman