Strategic Health Care Management: The Case of Aetna

Aetna Overview

Established in 1843 in Hartford, Connecticut, Aetna is one of the global premium providers for health care programs such as pharmacy, dental, workers’ benefits, and dental life insurance covers. The company offers benefits to more than 600,000 members globally with the main aim of delivering quality health care at more affordable costs as well as empowering individuals to adopt a healthier lifestyle. The company's portfolio includes corporations, governments, and other providers that extend all across the world.

AETNA MISSION AND VALUES                                   

MISSION STATEMENT

            The company is dedicated to helping clients gain health and financial freedom through the provision of cost-effective health care without compromising on the quality as well as ensuring the security of their finances against unforeseen health risks.

The company intends to continue building on its 160-year heritage through enhanced co-operation with patients, doctors, hospitals, and employers to build a more cost effective health care plan.

VALUES

  • Integrity: To be able to do the right thing for the right reason
  • Excellence: To be able to deliver quality and value in our products through essential and appropriate solutions.
  • Caring: To listen to our clients so that we can act with intuition and compassion.
  • Inspiration: To inspire ourselves to explore choices and make decisions that make the community a better place to live in.

Everything that is undertaken in Aetna commences with the values outlined above. These concise and strongly held set of beliefs reflect what clients can expect from the company. These values were created with the guidance of the more than 400,000 individual customer voices (Dialynas, Chew, & Kristof, 2010). These values intend to spark innovation in the products and services offered so as to drive the commitment to excellence in all that Aetna does.

TRANSFORMATIONAL OUTCOME

            The Aetna Quality Management (QM) program is a constant process that reviews and assesses the company’s operations, strategic direction, programs that seek to transform Aetna into a dynamic and modern entity by the year 2020.The QM program requires the company to engage other external institutions, peer organizations, and clients to be able to enhance clinical care and other related services. Some of the benefits expected to be reaped from the QM program implementation include:

  • Promotion of enhanced health and health care delivery that focuses on engagement.
  • Eradication of some of the disparities in health care.
  • The utilization of federal measures and standards

            The Quality Management Program is steered with four transformational outcomes that seek to address how the company can be able to fulfill their mission in the modern day environment (Ginter, Duncan & Swayne, 2013). The following are the three Quality Management facets that Aetna aims to address:

Quality Management Process: the application of CQI techniques will seek to include systematic follow up with interventions that allow for rectification of issues that have been identified with the use of internal surveillance and the analysis of complaints lodged by clients.

Racial and Ethnic Disparities in Health Care: The QM program will seek to address the current racial and ethnic disparities when it comes to accessing health care. These variations have been linked with the decline in the longevity of some of the most affected communities. The QM program seeks to address these issues so at to be able to provide an inclusive medicinal cover (Greener, 2015).

Quality Strategy Statement: The statement will intend to offer value by promoting member-plan-provider relationships to offer the desired health outcome.

AETNA STRATEGIC GOALS AND OBJECTIVES

            Four areas have been identified by Aetna in which the company must excel to adequately provide quality health care to its members. The following initiatives are meant to address the rise of specific ailments such as breast cancer and diabetes and as such, make their health care accessible to all.

Breast Health Initiative

            The firm intends to decrease the burden that comes with breast cancer in Hispanic and African American communities which constitute the largest minority groups in the United States. The goals of the program are to be able to examine as well as address some of the barriers faced during screening. The outreach program will stress the essence of mammography screening along with the risk that breast cancer possesses in this communities (Swayne, Duncan & Ginter, 2012).

Diabetes Initiative

            The incidence rate of diabetes continues to be on an upward trajectory with an estimated 40 million people expected to be suffering from diabetes globally. Aetna seeks to address this issue by creating awareness that targets individuals and communities that are more predisposed to the complication.

Depression Initiative

            Aetna is also focusing on health care physicians through training in order to provide first line treatment and management of behavioral complication faced by most patients. The plan is also to create awareness of some of the negative complications that arise from depression and other related behavioral complications.

TWOS MATRIX ANALYSIS OF AETNA

   Threats – T Nationalized health policies can impact the firm Economic crisis in various nations may threaten the survival of the company Different laws and regulation may affect the company’s efficiency and reduce its revenue    Weaknesses – W The company has less diversity in products and policies. Cost structure of the policies and products is relatively high as compared to those of other peer companies The online presence of the company is passive. High costs involved in training
  Opportunities-O The potentiality of mergers and acquisitions increases company’s market share. Opening economies in Business mergers with other companies may promote the market position of the company. The company is better placed to meet the changing needs of its clientele base. The company can introduce new products and services in both old and prospective markets. Globalization enhances the company’s ability to spread across the world. Global per capita income growth exceeding that of the United States  SO STRATEGIES Pursue new mergers and acquisitions in America and Africa.       (S1, O2, O3,O4,O6,)  WO STRATEGIES The company is better placed to meet the changing needs of its clientele base. (O3, O5, W1,)  
  Strengths – S An excellent brand that is effective in creating customer satisfaction, retention, and loyalty. Company implements cost-effective policies The company has favorable economies of scale that enable it to main its pricing power. Geographical coverage of the company enables it to reach a broad audience of customers.  ST STRATEGIES An excellent brand that is effective in creating customer satisfaction, retention, and loyalty.  (S1, T3, T5)   The company has favorable economies of scale that enable it to main its pricing power. (S3, T2, T1 )  WT STRATEGIES Reduce cooperate operation costs (W2, T1, T2, T3)  


References

Dialynas, A., Chew, D., & Kristof, K. (2010). Strategic Report for Aetna, Inc.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2013). Strategic management of health care organizations (7th ed.). San Francisco, CA: Jossey-Bass. Chapter 7, "Evaluation of Alternatives and Strategic Choice," pages 255-304.

Greener, I. (2015). Health management as strategic behavior: Managing medics and performance in the NHS. Public Management Review7(1), 95-110.

Swayne, L. E., Duncan, W. J., & Ginter, P. M. (2012). Strategic management of health care organizations. John Wiley & Sons.