Aetna Inc. is close to achieving one long-standing goal of its digital and mobile health initiative. But the bigger push to get more of the health insurance companys 19.5 million health plan enrollees to use its mobile health tools and app features is just beginning, says Chris Riedl, Aetna executive director, national businesses strategy and product management.

Earlier this month Aetna rolled out its digital payments estimator tool to consumers enrolled in Aetnas commercial health insurance plans in Iowa and Nebraska. The estimator, available through Aetnas mobile app or through its desktop digital health portal, gives users access to current pricing information directly from the negotiated contracts Aetna has with thousands of healthcare providers nationwide. By accessing the Aetna app on an iPhone, iPad or Android device, users can get out-of-pocket cost estimates and related information on more than 650 non-emergency healthcare procedures such as colonoscopies, magnetic resonance imaging, or MRIs, computerized tomography, or CAT scans, natural child birth and Caesarian sections, or C sections.

The estimator tool gives users up to 10 different estimates at one time based on where the user is looking for a specific procedure, such as at a particular hospital, clinic or doctors office. Aetna says its health cost estimator is superior to those offered by many other health insurers or commercial health data services that dont display the latest available pricing information because the underlying data is based on historical claims information and may not include the most recent negotiated provider rates of payment and paid claims.

Aetnas estimates are derived from actual claims for a procedure and then calculated to include information based on the members specific benefit plan, such as their deductible, co-payments and Aetnas negotiated rates. The tool also includes data on out-of-network providers, says Riedl. Its important that these digital and mobile tools give our members access to the latest information, Riedl says.

The digital estimator tool has been available on Aetnas digital healthcare portal for desktop access for several years. But Aetna spent much of this year incorporating the estimator tool into its mobile app. Iowa and Nebraska are the latest areas to get access to the tool on desktop and in app form now that Aetna has fully integrated its 2013 acquisition of managed healthcare company Coventry Health Care Inc. Aetna first had to complete the deal, integrate Coventrys various computer and Internet systems with Aetnas systems before projects like the digital tool for pricing could be implemented. That technology integration process is now complete including giving Aetna plan enrollees in Iowa and Nebraska access to digital and mobile health tools. About 98% of Aetnas health plan enrollees have access to the digital estimator tool in app form and the mobile tool will be available nationwide in early 2016.


The digital estimator is popular with Aetna customers, Aetna says. Figures arent yet available for 2015. But in 2014 Aetna members accessed the payment estimator on desktop computers and mobile devices 1.6 million times for an average of 133,609 visits per month, a 23% increase from monthly visits of 108,625 from the previous year, Aetna says. The rollout to Iowa and Nebraska is a reflection of Aetnas growing presence in those states and the continuing integration of Aetnas capabilities with Coventry products, Aetna says.

Aetna has been building up its digital delivery of health insurance and related information since 2005 when the company first launched a desktop portal. Today about 15 million of the companys 19.5 million healthcare plan enrollees have access to the portal. The next big push is to make the portaland scheduled new features for the portal available for mobile users. Mobile health is a big development priority for Aetnas digital program, Riel says. With mobile weve only begun to scratch the surface, she says. Today about 14 million users have downloaded Aetnas main app. With the app, users can search for a doctor, dentist, or a facility, such as urgent care centers and walk-in clinics. Users also can log into a secure section of the portal to view claims, coverage and benefits, personal health records and identification card information.

Aetna predicts more of a shift to mobile over time. In the past decade there has been a significant adoption of mobile devices, Riedl says. People tend to use their personal computers during the work day, but mobile devices are becoming the primary way to access the web, and we want to be able to optimize these digital healthcare tools over all types of devices.

Aetna has been making a substantial investment in digital and mobile health technology primarily through acquisition since 2011. In November 2014 Aetna acquired bswift for $400 million. Bswift is a healthcare technology platform provider that Aetna says offers a retail shopping experience for health insurance exchanges and employers nationwide. Additionally, bswift offers benefits administration technology and services to employers. In 2012 Aetna also acquired Healthagen, the developer of iTriage, a mobile app that provides users with medical and related diagnostic information and access to local providers.

Aetna will be rolling out more mobile app upgrades in 2016, Riedl says. Next year all Aetna mobile app users will have access to an iTriage feature that lets the user schedule and conduct virtual doctor office visits.


Aetna, which in July announced a $37 billion deal to acquire health insurer Humana Inc., sees digital and mobile health technology becoming much more mainstream, especially as more consumers buy insurance on private and government health exchanges. Digital and mobile tools give consumers more complete, personalized picture of the costs involved with healthcare, Riedl says.