Corporate Research Group’s Weblog

Speaking at the Oppenheimer healthcare conference in New York today, Aetna president Mark Bertolini said his company is “somewhat insulated from reform” because 85% of the company’s membership is in large groups (i.e., 50+ employees).  Most of the impact of reform will be felt by companies with lots of individual and small group members, such as Blue Cross Blue Shield plans.  About 6% of Aetna’s membership is in small groups (2-49 employees) and 2% is in individual.  This backs up an argument put forward in The Wall Street Journal (see prior post)  suggesting that the varied interests of health plans has caused an indudtry rift over whether to support or oppose reform.  Bertolini also pointed to some challenges the company faces in 2010, including the potential for additional in-group attrition and COBRA uptake related to the economy, medical cost and pricing pressures, uncertain risk membership, lower Medicare reimbursement and increased selling, general and administrative costs.  The company maintains a “bias toward profitability over growth,” he said, meaning Aetna will sacrifice membership for margins.