Aetna, Inc. was established in 1853 and offers health insurance options for purchase. The main product portfolios include health insurance products with medical, dental, pharmacy, behavioral health, group life and disability plans. This essay will analyze the company’s structure and environment and provide recommendations on strategies that the company could take to improve performance. Aetna’s Mission Statement is “At Aetna, our Mission is empowering people to live healthier lives. We achieve that with Integrity, Excellence, Caring and Inspiration – Core Values that put the people we serve at the center of all we do” (The Aetna Story, 2015). The company has a robust Code of Conduct that all employees are expected to follow at all times. Each …show more content…
This segment provides coverage for employees (and sometimes their families) who are on assignments for their companies in another country as well as individual policies for people visiting other countries. These policies include medical coverage and access to clinicians who can help with pre-trip planning based on the country of destination and can help locate providers in those countries. The customer service centers are open 24 hours a day, 7 days a week and can answer calls in eight languages. Aetna has also been able to build a network of providers and has direct settlement agreements with providers around the globe. (Aetna International, 2016). A threat to Aetna is in the area of technology. This is an area that is constantly changing, and while Aetna has been innovative in the past, if they do not stay ahead of the game, competitors could get ahead and steal customers away with new …show more content…
302.) A solid short-term objective for Aetna would be focus on the four states where they have retained ACA coverage to determine a way to make the coverage affordable for members but still profitable for the company. Functional tactics are “detailed statements of the ‘means’ or activities that will be used to by a company to achieve short-term objectives and establish competitive advantage” (Pearce & Robinson, 2015, p. 204). Functional tactics that may help Aetna meet this objective include restructuring the benefits of the ACA plans to still meet the guidelines of the law but making the plan less expensive to administer and recognizing that the members who are typically enrolling in these plans are utilizing more medical services and therefore adding medical management services that can help members choose providers and services to help reduce costs to both parties. Mark Bertolini became CEO of Aetna in 2011. He has a great deal of passion about helping to make Aetna’s membership, and society as whole, healthier. He has helped introduce mindfulness and other healthy living programs to the employee population at Aetna, many of which have then been introduced to the Aetna membership. He recently raised the company minimum wage from $12 an hour to $16 an hour, knowing that employees who make more are better able to handle their personal business,
Mission and vision statements communicate strategic goals. “To provide superior patient-centered care using appropriate and innovative evidence-based practices” is a mission better aligned with Amedisys new direction. Additionally, “Drive growth by delivering a full range of holistic health care services, while cultivating a culture of compassion” is a vision that could be used to inspire employees to achieve Amedisys’ purpose.
Ghosh, C. (2013). Affordable Care Act: Strategies to Tame the Future. Physician Executive, 39(6), 68-70.
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
Health Maintenance Organizations, or HMO’s, are a very important part of the American health care system. Also referred to as managed care programs, HMO's are combinations of doctors and insurance companies that are formed into one organization. This organization provides treatment to its members at fixed costs and decides on what treatment, if any, will be given based on the patient's or doctor's current health plan. Sometimes, no treatment is given at all. HMO's main concerns are to control costs and supposedly provide the best possible treatment to their patients. But it seems to the naked eye that instead their main goal is to get more people enrolled so that they can maintain or raise current premiums paid by consumers using their service. For HMO's, profit comes first- not patients' lives.
Hospital Corporation of America (HCA). Staff Analysis Statement of Problem HCA, after following a conservative financial policy since its establishment, has entered the new decade preparing to make some changes in order to realign their financial strategy and capital structure. Since its establishment, HCA has often been used as a measure for the entire proprietary hospital industry. Is it now time for the market to realign their expectations for the industry as a whole? HCA has target goals that need to be met in order to accomplish milestones in the future.
Formed in 1998, the Managed Care Executive Group (MCEG) is a national organization of U.S. senior health executives who provide an open exchange of shared resources by discussing issues which are currently faced by health care organizations. In the fall of 2011, 61 organizations, which represented 90 responders, ranked the top ten strategic issues for 2012. Although the issues were ranked according to their priority, this report discusses the top three issues which I believe to be the most significant due to the need for competitive and inter-related products, quality care and cost containment.
The business being studied is that of a Pharmacy Benefit Management company called Prime Therapeutics. They are a privately held LLC headquartered in Bloomington, MN. It manages pharmacy benefits for health plans, employers and government programs, including Medicare and Medicaid. It also processes claims and delivers medicine to members, offering clinical services for people with complex medical
Threat of new entrants is relatively high. Companies forming alliances are potential rivals. Even if earlier such company was not considered to be a threat, after merging with some research and development company or forming alliance with another pharmaceutical company it would become a rival to Eli Lilly. The threat is however weakened by significant research and development costs necessary to successfully enter the business. Eli Lilly’s focus on a relatively narrow market of sedatives and antidepressants weakens the threat of new entrants, but other products that form lesser part of company’s sales such as insulin and others are exposed to high threat of new entrants. The need of obtaining certificates and licenses also weakens the threat of new entrants. Discussed above leads to the conclusion that threat of new entrants is medium.
Obamacare, otherwise known as the ACA (Aaffordable Ccare Aact), will significantly change major aspects of theour health care system here in America. Without a doubt, our current system has its issues, especially the costs related to health insurance and medical care were rising far too quickly (Pattron, 2013). Some may believe chainsaws have been called in to fix issues that could possibly be fixed with a mere scalpel. In spite of everything, typically, our health care system contained many more strengths than weaknesses. Considering the number of patients that have come from various countries to seek medical care in the U.S., the entire world sincerely agrees. However, despite the many strengths, changes have and will arrive that will affect all who seek medical care in the U.S.
My current employer, Mayo Clinic, is a world renowned not-for-profit hospital that has been established for 150 years. Mayo Clinic is the first and biggest integrated not-for-profit medical group practice in the world and is a well-known brand name that is recognized world-wide. Working for an organization where the primary value is the needs of the patient come first, the organizations domain is held to a higher standard. The mission statement is to encourage hope and contribute to health and well-being by providing the best care to all patients through integrated clinical practice, education and research (Strategic statement of Mayo Clinic, 2012). The vision statement is that Mayo Clinic will offer an unparalleled experience as the most trusted partner for health care (Strategic statement of Mayo Clinic, 2012). In the medical field, innovations, research and technology motivate the business to perform and deliver care in a new standard. Mayo Clinic has a logo of three shields that are interlocked, presenting patient care, research and education.
The main advantage of the Affordable Care Act is that it lowers health care costs overall by making insurance affordable for more people. First, it wi...
The case under analysis, Eli Lilly & Company, will be covering the positives and negatives with regards to the business situation and strategy of Eli Lilly. One of the major pharmaceutical and health care companies in its industry, Lilly focused its efforts on the areas of "drug research, development, and marketed to the following areas: neuroscience, endocrinology, oncology, cardiovascular disease, and women's health." Having made a strong comeback in the 1990's due to its remarkably successful antidepressant Prozac, was now facing a potential loss in profits with its patent soon to expire. The problem was not only the soon to expire patent on Prozac, but the fact that Prozac accounted for as much as 30% of total revenue was the reality Eli Lilly now faced. (Pearce & Robinson, 34-1)
The purpose of ACA implementation is because many people are uninsured due of various reasons, some of the reasons are financial hardship, pre-existing conditions, and work status. The most effective solution to these issues was to formulate
This study is related to a case conducted at Faith Community Hospital to assess the problems due to issues with their mission statement and how it is being interpreted. According to the CEO of Faith Community Hospital, very few of the members and partners seem to be following the mission statement. There are issues with organizational processes, ethics issues, and communication systems. Many staff members are operating as individuals and not as a collective unit based on their values. A moment's distraction can result in a tragic outcome.
The mission statement of the company was “As we grow as a company, it has become more and more important to explicitly define the core values from which we develop our culture, our bran...