Aetna Buys Exchange: A Case Study

To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization's own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must

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.

The key issue facing GEHS today is that despite high potential growth in both the developed and developing markets traditional B2B marketing lines are slow; the buyers control the power and the end consumer (patients) sees GEHS and its competitors as “faceless” corporations and their countries health care services as lacking. End users want cheaper, better quality, and more accessible healthcare and GEHS wants to grow market share and improve reputation.

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,

The firm shows positive health for the Shareholders Equity with an equity ratio of 44.2% in 2011 and increasing to 45.2% in 2012. Calculating the percent of total assets that shareholders would receive in the event of company liquidation looks positive and very healthy for any investors or shareholders of this firm. The interest coverage ratio is also at a value that is significantly positive 14.0% in 2011 and 12.8% in 2012. Although 2021 shows a decrease, the company is still very capable of generating sufficient revenues to cover their interest payments on any debt they have incurred.

It is necessary for a firm to expand in order to gain profits or leverage in a market place. One of the ways firms can do this is by executing a merger. There are two types of mergers, horizontal and vertical mergers. There are many incentives for companies to perform either type of merger; however, both types of mergers will always raise suspicion when being executed because they are usually perceived as anticompetitive. In order to prevent an anticompetitive environment, our government established a federal agency called the Federal Trade Commission. Their job is to review the activity of any given firm and decide whether or not to allow them to continue. Presently, CVS and Etna are currently undergoing a vertical merger to gain profits and

As value customers of the Anthem, Inc. we believe it is important to keep each one of you informed of any incident that might affect your business with us. Your privacy and security is our priority for the reason Anthem, Inc. would like to inform our customers of a recent phishing attack. Unfortunately, we have experienced similar attacks in the past which led many of the employees and customers’ data exposed to hackers. Even though this is a serious matter for the company and the customers it is important for us to make our customers aware that phishing attacks are common and they cause huge losses to both the customers and the companies (Wright et al., 2014). Our most recent attack took place on April 2014 and it affected about 80 million identifiable data stolen via phishing emails. The

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 healthcare system should provide quality and efficiency services with high quality to all citizens regardless of the premium that the contribute. Better wellness, preventative and value-based insurance benefits will allow a healthier population to exist for our nation. Technology is the key to a healthy heath care system. A successful system will ultimately consist of patient satisfaction, healthcare outcomes, and financial sustainability. However, a quality system will address quality through provider selection, internal peer review, and external accreditation for my ideal health care system. Finally, I think technology through EHRs will be the ultimate key to the excellent health care. Technology empowers people with material to make the best decisions. In health care, giving patients, doctors, insurance companies and the government the means to run a more efficient, quality driven, evidence-based system of

What institutional or corporate vision should be articulated for FutureCare Medical Group with respect to the proposed on-line patient services.

The health care industry is one of the most dynamic and delicate industries in the U.S. having experienced healthy and substantial changes for the last thirty years most of which have aimed to improve health care management and services delivery to the patients. The changes have enabled the integration of technology into the industry such as in the area of informatics, science and research and payment services and clinical treatments. The health care sector has introduced various changes to address disease and health care management such as the Modernization Act of 2003, the Patient Protection Act and Affordable Act, which aim at improving health provision and most

Anthem Inc and Cigna Corp are suing each other for breaching their merger agreement. Anthem and Cigna originally had a deal made in 2015 that would consolidate the top of the industry in to a few big corporations, but there were behind the scenes conflict between the two partners. The Justice Department filed an antitrust suit to block the deal. Federal judge decided against the merger and Anthem appealed the verdict to the Supreme Court. Anthem decided to terminate the merger agreement stating that Cigna former partner sabotaged the deal and stated that is would seek to claim massive damages against Cigna.

According to a study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in any given year approximately 14 percent of adults in the U.S. misuse alcohol. George Koob is the Director of the NIAAA, he states that the risk of suffering with an alcohol use disorder (AUD) has been on the rise for the last 10 years.

Most of the patient is not entitled to out of network advantages. This leads to the major loss for the provider even after rendering the standard service. Acer health overcomes this

Health care system is known to be extremely complicated and expensive, it takes an enormous amount of time and money to operate and maintain, even with the huge amount of funding spent annually regarding health care, the current health care system still receives biased and ambiguous feedback, when healthcare comes to the mind of general public, it is often related to terms such as expensive, over-complex and profiling, therefore, with the rapid development of wireless technology, this rising technology has helped the current health care system in numerous ways and is expected to bring hope to the health care industry. "Subversion" is becoming the new propaganda industry and capital market this year, which means newly developed technology is