Payers' Optimism Tempered By Economic Realities

Margaret Dick Tocknell, for HealthLeaders Media , August 15, 2012

Here are some of the highlights:

Q2 Profit: -15%
Analyst expectations: Beat
Forecast: Positive

The insurer is hanging its hat on its Accountable Care Solutions (ACS) business, which is developing a nationwide network of accountable care organizations. Thanks to increased demand, the company is accelerating its spending on the business.

During the second quarter Aetna announced an expanded relationship with Banner Health Network in Phoenix and new ACO partnerships with Hunterdon Healthcare Partners in New Jersey and Aurora Health Care in Wisconsin. It also has a joint venture underway with ACO partner Inova Health System to create Innovation Health Plans, which will offer products in Northern Virginia.

Aetna officials say the ACO arrangements provide the insurer with a 10% to 15% premium advantage over the average price point of competing products.

But don't look for Aetna to jump into the acquisition fray to grow its Medicaid membership. For now Aetna will stick to organic growth. CEO Mark Bertolini told analysts the insurer isn't interested in "bulking up Medicaid at the current prices of those assets."

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