The Exec: For Aetna's Terri Swanson, Better Outcomes Don't Have to be Complicated, Part 2

The Medicare President talks health equity, CVS Health growth, and results optimization in part two of this HealthLeaders exclusive.

In 2024, Aetna will offer 747 individual Medicare Advantage (MA) plans, the largest number in company history. While this suggests a complicated strategy, Aetna Medicare President Terri Swanson likes to keep things simple as she and her organization optimize for better outcomes. Read part one of this conversation here.

Read on for more examples of how Swanson and Aetna are building traction, which updates HealthLeaders’ Payer Week conversation with the MA exec in June.

HealthLeaders: What are Aetna’s offerings in the emerging specialized population health plan space (e.g., plans for women, Spanish speakers, those with specific chronic conditions, etc.)?

Terri Swanson, President of Aetna Medicare: We are not in the Chronic Special Needs Plan space today, but we have — and as part of CVS Health — a broader initiative around health equity. We have a lot of work underway to truly improve the difference in healthcare outcomes.

We have an entire medical division that’s focused on health equity that's helping to drive initiatives end-to-end throughout our enterprise.

[Note: In 2020, Aetna launched its Multicultural Initiative, which is already generating results. Its components include data and technology, community and provider engagement, and multicultural care management. The latter includes care managers with diverse backgrounds, a focus on culturally relevant clinical and motivational interviewing training, and care planning that includes a Multicultural Clinical Assessment. Clinical focus areas include nutrition and medication support.]

HealthLeaders: What are the big topics that everyone is talking about with 2024 MA enrollment and what is different or unique this year?

Swanson: There are certainly things that are going to change but also, quite frankly, things that really don't. Starting with the things that don’t, people are going to continue to have a very high degree of choice. Figuring out how to cut through the clutter and choose the plan that’s right for them is something that all Medicare beneficiaries are going to need to be able to do.

There are a couple of key things here. The process doesn't have to be complicated or intimidating: Does the plan fit your budget, is your provider or pharmacy in your network, and are your prescription drugs covered at a preferred cost? Are you someone who likes to go to the gym? Do you need your plan to help pay for healthy food or transportation to the doctor's office? As needs change, I think there will be a plan for every person. There are a lot of good plans with those benefits.

HealthLeaders: What else would you add?

Swanson: The population that is going to come to our healthcare plan, they're going to compare us to buying things on Amazon or hailing an Uber. So, we have to ensure we provide the right digital and online experience that complements their experience with the healthcare system. We have to be prepared to meet people where they are and help them to engage in a way that works for them.

With CVS Health, a lot of that applies to what we're doing as an enterprise and a Medicare plan. We're delighted to have Signify Health and Oak Street Health now as part of the CVS Health family. Signify, for example, performs Healthy Home Visits that help us understand if a member has needs that haven't been identified yet. And Oak Street Health does a very comprehensive job of treating Medicare beneficiaries with complex conditions.

Being able to bring those types of organizations to bear — along with Aetna coverage, along with CVS Pharmacy — creates a really exciting path where we can bring all of that together. And hopefully, in a very simple and easy way for our customers.

HealthLeaders: How do you leverage your PBM and IT backgrounds to optimize results and what is a good example?

Swanson: My background allows me to take an analytical approach to solving complex problems in the healthcare space. I think having a background in technology helps shape and structure how I approach opportunities. For example, at Aetna, we’re always thinking about innovation and finding ways to create better solutions and simplify the way people get care.

I’m often able to leverage my PBM background here at Aetna and work closely with our Medicare Part D team to design our prescription drug plans. Data shows that 3.5 million Americans aged 65 and older have struggled to afford their needed prescription drugs. With my expertise, I can better help tailor our prescription drug benefits to ensure Medicare consumers have coverage for their medications at an affordable cost.