MANAGED CARE September 2000. ©2000 MediMedia USA
Sometimes breaking old ground can be just as satisfying as breaking new. Take our cover story. The article [1] looks at how the corporate cultures at Aetna U.S. Healthcare and Kaiser Permanente shaped their reactions to recent financial setbacks and positioned them for the future.
What these two plans are looking at, experts believe, is a health care system moving toward defined contributions. Aetna's new CEO, William H. Donaldson, made his reputation by blazing a path for a pension system linked to defined contributions. Kaiser's chief, David M. Lawrence, sees defined contributions as being part of a myriad of health benefits choices that the consumers of the future will have.
This focus is perhaps the most encouraging thing to arise from financial instability. Despite the heavy hits they've taken, Kaiser and Aetna are still savvy enough to spot a trend and ambitious enough to capitalize on it. Both of them. For, as many experts pointed out, the plans seem to be "moving toward the center."
But are they? More to the point, where is this middle that everyone is so fixated upon? Is it the halfway point of patient and/or physician satisfaction, located somewhere between the largest not-for-profit and for-profit organizations? That suggests that Kaiser and Aetna are the yin and yang of the health world. Are there really no plans more bottom-line oriented than Aetna, or physician-friendly than Kaiser?
The two, we have said, should not be compared because they must answer to different masters. Further, this review probably couldn't have come at a better time for Kaiser, or a worse one for Aetna. Kaiser recently announced a huge profit. Aetna is taking a beating.
Our bottom line does not involve tracking how they may be moving toward each other. It's more important to see how both Aetna and Kaiser are moving into the future.