Aetna’s newly named head of its Southeast region said the company plans to launch accountable care organizations in the Georgia and Florida markets in coming months.
Those networks, promoted in the 2010 health reform law (the Affordable Care Act), are combinations of physicians, hospitals and insurers that seek to deliver high-quality, efficient medical care.
Mark LaBorde, an Emory University graduate who worked for Aetna in Georgia for 13 years, also said Wednesday that the company’s acquisition of Coventry will bring the combined companies’ membership to more than 700,000 in Georgia.
“Coventry is prominent in the Southeast and in Georgia,’’ LaBorde told GHN in an interview. “Georgia presents us a great deal of opportunity.’’ He was the Aetna market president in Florida prior to his promotion.
The Coventry acquisition, completed last month, is part of a major trend toward consolidation in the health care industry. In December, the parent company of Blue Cross and Blue Shield of Georgia, WellPoint, bought Amerigroup, which has part of the Georgia Medicaid and PeachCare business.
“You’ve got an arms race going on in health care,” Robert Laszewski, a health care consultant, told the Huffington Post when the Aetna deal was announced. Laszewski said health insurance companies, hospitals and other organizations are merging into bigger entities in hopes of curbing their own costs and grabbing larger shares of the markets being reshaped by health care reform.
LaBorde said the Coventry acquisition creates a big integration challenge. He was at Aetna when the company acquired U.S. Healthcare and Prudential.
The Coventry integration will be “thoughtful and deliberate” to minimize disruption to consumers and employers, he said.
Coventry brings more experience in the Medicare and Medicaid markets, he said. While Coventry has no Medicaid business in Georgia, it does have Medicare Advantage members here.
Aetna and Coventry have each applied to be part of the Georgia health insurance exchange. A company spokesman, Walt Cherniak, said the company will participate in exchanges in about 15 states.
The exchanges, which will serve as online health insurance marketplaces, are being launched under the Affordable Care Act. They are set to begin enrollment in October.
The Southeast territory for Aetna reaches from Virginia and Maryland south to Florida and west to Arkansas and Louisiana.
With the changes brought by the Affordable Care Act, LaBorde said, “any region is a dynamic marketplace. The Southeast is no exception.’’
“We have to be nimble, and react to developments that will happen over the next few years.’’
Georgia is the No. 2 market for Aetna in the region, trailing only Florida and its 1.3 million members. The combined companies will see continued growth in the individual and small employer market, LaBorde predicted.
The company that develops from the merger won’t look like either Aetna or Coventry as they now exist, LaBorde said. “It will be a new organization,’’ capitalizing on each company’s strengths, he said.
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