Aetna: A Target Market Analysis Essay

Unfortunately, Aetna’s compliance with the implant carve-out over the past five years has been anything but straightforward. By 2011, Aetna began to deny additional payment for charges billed using revenue code 278, despite its contractual obligations to pay the Hospitals for other implants billed using that revenue code. Instead, Aetna appears to be relying on an internal policy it has promulgated in an effort to unilaterally reduce its payment obligation for “Other Implants.” This internal policy, which is called the “Implants and Supplies Policy” (the “Implant Policy”), attempts to limit the implant carve-out payment to what the Implant Policy refers to as “Implantable Devices.” The term “Implantable Devices” is define by Aetna

Aesop is a firm that started its operations in Australia and works in an extremely competitive environment. The main objective of this marketing plan is to introduce the products of Aesop to the global markets. It becomes essential to analyze and research the product as well as the market in order to create a stronger strategy fit and align all of the marketing activities and efforts to the marketing goals and needs of the potential consumers. Identification of appropriate segments and markets is an essential foundation for the success of the product and the organization.

The short term decision to start in a limited area and then only grow by one state in 2015 may have served the purpose of limiting risk during a time of uncertainty, however, in the long term, penetrating into new markets may be difficult because individuals currently enrolled are automatically re-enrolled at the end of the period. For Aetna, it may be harder to pull a member from a plan that they currently have. The largest healthcare insurance company UnitedHealth was more conservative than Aetna in the first two years, with participating starting in five states in year one then increasing to 24 in year two. With the addition of UnitedHealth in the same markets as Aetna and the unknown risks associated with new enrollees for the 2015 plan year, the short term could be crucial for Aetna. If Aetna is able to add to 2014’s positive results, and increase membership in markets that UnitedHealth entered, it will go a long way toward their long term goals of increasing membership in the individual and small group sector (Demko, 2014).

Health insurance and the affordable care act is a major topic in the United States today. This being said, there are many questions that run through one’s mind when the topic is discussed. Questions such as, what exactly is health insurance? What is the Aetna-Humana merge, and how beneficial is it? Should healthy citizens help pay for citizens with prior known health issues? Should people with preexisting conditions even have the option to purchase insurance to help cover medical cost? Although the Affordable Care Act has been in effect for a few years now, there are still some problems today the health insurers face because of this law.

Castor Collins Health Plans is a regional HMO founded in 1999 in the state of Pantome (University of Phoenix, 2011). Using a capitation model to pay its network of health providers, the HMO provides health insurance and health care services to enrollees statewide (University of Phoenix, 2011). Castor Collins currently has 100,000 enrollees throughout Pantome and is actively pursuing to companies to increase this number. The fact that Castor is currently in expansion mode may give the companies an advantage in terms of bargaining for rates. Because Castor is a small company trying to become a big one, acquiring new clients is very important to the company.

Aetna’s customized iTriage app helps employers make better health care decisions based on appropriateness and affordability of care. Aetna launched this customizable app to allow customization of information for consumers based on their specific health benefits plan. It helps employers to understand how using an in-network health care provider can be more affordable, which can also be used to create cost savings for employers and reduce administrative work for health care providers, who will benefit from informed patients, who have selected the right physician, facility and level of care based on their individual needs. The iTriage app is Aetna’s vision of creating a better healthcare experience for their customers and their employers (Aetna,

Anthem policy is driven by their focus on creating the best health care value in the industry, ex-celling at day to day operations and executions and capitalization on new opportunities to drive growth. With a reputation for innovation, Anthem Inc affiliates are committed to establishing a relationship with customers, physicians, hospitals and other health care clinicians as trusted partners. This company labeled as one of the largest health care insurance providers ("Products and Services”,n.d). They deliver many leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a broad range of specialty products like life and disability insurance benefits, dental, vision, behavioral health and long-term care

Today, most people purchase health care insurance through their employers. Since the rise of the Obamacare and other global insurance companies have made their way to the market people are now choosing individual insurance company. Some insurance companies may offer individual or family policies or even student policies, but finding the best policies and provider depends on how well the marketers use the marketing strategies as well as the marketing mix. Cigna is a medical group which was started back in 1968 by nine internal medicine physician in a small office. “Now 38 years later, this medical group has grown from one

Aetna Medicare Plan (PPO) offers advantages such as comprehensive annual examination and fitness facility membership at without a cost, according to Aetna. It also offers in-network coverage regardless of where a member travels to.

Aetna is one of the nation's driving differentiated health care benefits companies, serving an evaluated 46.7 million individuals. Aetna offer a wide extend health insurance products and services including medical, drug store, dental, behavioral wellbeing, group life and disability plans.

The article “What the CVS-Aetna deal means for the future of health care,” by Carolyn Y. Johnson, introduces the proposed merger between CVS and Aetna. CVS is the largest pharmacy chain in the United States and Aetna is the third largest health insurer in the United States, which will create a business partnership that could transform how healthcare is dealt with in this country. Overall, the article was neutral in its reporting. It presented both the advantages as well as the drawbacks of this deal. The short term advantages of this deal would be that copays may initially be low for customers of both CVS and Aetna. This may lead to more affordable medications, but this is completely dependent on their choice to lower or raise prices. However,

Although Anthem is regarded as highly lucrative, the company’s profit margins are extremely low due to the highly competitive and regulated industry. Because there is limited opportunities for market growth, health insurance companies remain competitive by merging with other companies. Anthem is currently in the process of finalizing an acquisition deal with Cigna. This deal has been faced with much scrutiny and pushback from government due to monopoly regulations. If the deal does not go through, Anthem will have to pay a large penalty fee to Cigna. Along with this financial cost, Anthem would also lose time and resources that they have dedicated to this strategy over the past two years. Because of the competitive environment and high stakes, Anthem began cutting costs throughout the company.

Lateral segmentation is an array of segmentation tools that is already possessed by marketers (Fortenberry, 2010). Health care marketers examine segment and produce any faults that may need to be addressed during the use of segments. Lateral segmentation will help health care systems to insure that it does not have to focus on certain specific categories at a period of fourth dimension. Regarding lateral segmentation, the organization will make plans and strategies only for a specific group of customers. Therefore, the efforts of the marketing team of health care organization shall not be wasted at any point of time during its efforts. A panel of distinguished healthcare executives shared their thoughts on the importance of active and visible

The aim of this background research report is to establish general background details on the company Aetna. This report will identify some key characteristics about the company. This will include a brief overview of the company history. Additionally, this report will provide details about the company mission, the range of services that Aetna provides, as well as logistical details of how Aetna goes about its operations. Lastly, this background research report will go over a few examples of how Aetna has appeared in recent news articles. Aetna’s financial reports are due in the last month of the year, December, so because of this time frame, a majority of the information in this research report will be in regards to publicly available information from 2015 and prior. By aggregating all of these details about Aetna, the report can provide insight into complex structure of the company, which may be influential in regards to internal communication issues within the organization. Synthesizing all of these details together into this report will allow for a complete story of the company that was assigned to the SI-506 group.

The central concept of marketing is the exchange of something of value between the provider and the purchaser. Determining what the consumer need, want and desire and delivering it better than the competitors is the goal of marketing (Longest, Rakich and Darr, 2000). Healthcare is becoming more business oriented and using marketing tactics to increase consumer use of the services and products the health care system offers. Ensuring marketing of the right products and services is successful the organization’s mission and marketing need to be in alignment. This alignment begins with the strategic planning process, which