Q&A: Allina Health | Aetna CEO on the joint venture's first year

First announced in 2017, the joint-venture health plan between Allina Health in Minneapolis and Aetna hit a milestone in its first quarter of operations: more than 12,000 enrollees.

"It was an aggressive, active first year," Allina Health | Aetna CEO Tom Lindquist told Becker's Hospital Review in an interview. He joined the health plan, which offers Medicare Advantage and employer group policies, in March 2018 after his tenure as president of Molina Healthcare's South Carolina plan.

Here, Mr. Lindquist answers questions on Allina Health | Aetna's first year, what's on the horizon for the health plan and the biggest challenge health insurance CEOs face today.

Editor's note: Responses have been lightly edited for clarity and length.

Question: When you took over the CEO role, what goals did you make for Allina | Aetna?

Tom Lindquist: It was about building the plan. I've had to hire a senior team and do everything from finding an office space to building an employee handbook to making sure our call center and claims infrastructure were up and running … so it really was about getting the plan functional and operational. Ensuring our network and systems were in place and fully integrated with the provider system, building a brand in Minnesota, and having a successful Medicare Advantage open enrollment were some of our initial goals for 2018.

Q: How many people from Allina versus Aetna staff the plan?

TL: The joint venture's structure is governed by an eight-person board of directors, four chosen by Aetna and four chosen by Allina Health. Myself, the role of COO, CFO, CMO — all of those key leadership positions are Allina Health | Aetna employees and report to me.

In terms of staff and support, we get a lot of that support through individuals who are directly assigned to Allina Health | Aetna but may work for, or get their paycheck from, either Aetna or Allina Health as a function of the ownership structure. So there are about 200 to 300 individuals at any point in time that are working on the Allina Health | Aetna health plan, but the direct employees are limited to the leadership team.

Q: How has the transition been from working at Molina in South Carolina, which specializes in Medicaid, to a payer that's more closely aligned with a provider?

TL: It's been a breath of fresh air to have a payer and a provider with owners whose mission truly is aligned. Allina Health, with its goal to innovate care models and Aetna's goal to accelerate local health management — when you look at those companies independently, it's impressive. But when you put them together, you see the goals and objectives were very much aligned.

Q: What have you had to learn about your new population to make Allina Health | Aetna a success?

TL: The population I managed in South Carolina was strictly government programs, primarily Medicaid, and I also had a dual Medicaid-Medicare program. Minnesota is known as being one of the healthiest states in the country, but it also has some of the highest costs. As I have been working in the state again, it's about transitioning out of the Medicaid space and into the commercial space.

There's also a sense of optimism for the market in Minneapolis. It has been a closed market for a long time. With the change in the legislature allowing for-profit companies to come in, it's bringing a sense of revitalization and that innovative environment that has always existed in Minnesota now is able to apply to the health insurance market. I'm excited to see what this environment will look like in three to five years.

Q: What's on the horizon for Allina Health | Aetna?

TL: Our short term goal is to continue to make inroads in Minnesota, build our brand, build trust in the community and work with our provider partners to improve outcomes. We're about a year in, we've had customers now for about six months, so it's to continue working, to drive innovation and cut some costs and friction out of the system.

We are also working with our partners at Aetna and Allina to develop and implement innovative solutions that will take waste out of the system and make it easier for the providers to do their job. Things like improving the prior authorization process to making healthcare a little easier to understand by combining explanation of benefits the patient gets from us.

Q: What's the biggest challenge health insurance CEOs face?

TL: The healthcare environment is constantly changing, but one thing that hasn't changed yet is incentives just aren't aligned. I think when you have misaligned incentives, focusing on outcomes is more difficult than it should be and cost tends to be higher on the priority list than results. It's navigating the space where the system is inherently flawed to drive improved results for the individual — not for the member or the patient — but individual.

More articles on payers:
UnitedHealth CEO: Optum won't build hospitals
CMO Dr. William Shrank on Humana's physician strategy, 'Medicare for All' and home care as the Netflix of healthcare
Rutgers partners with Horizon BCBS for medical research project

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