Aetna’s Firdaus Bhathena Discusses The Rise of Consumerism in Digital Health

On August 7th, Colorado’s payers, providers and innovators gathered for Prime Health’s Employer Health Innovation Summit. In partnership with Bach Health, Prime Health welcomed Firdaus Bhathena, Chief Digital Officer at Aetna, as the keynote speaker. Firdaus shared his insights on how companies such as Aetna are evolving to meet the changing needs of healthcare consumers. Following are some highlights from the event.


Firdaus opened his presentation by asking the audience to describe what consumer want in healthcare. “Easy, interactive and transparent” were at the top of the list.


“When you look at a person’s overall wellness, 10% of it is determined by clinical health, 30% of it is determined by genetic factors, and the remaining 60% is based on social determinants,” said Firdaus. “Right now, we’re only addressing clinical health.”

Firdaus also noted, “My primary care physician doesn’t influence my health. I only see him once or twice a year.”


“Your zip code and socioeconomic status is more important than your genetic code,” Firdaus emphasized. Research shows that overall health is not just a result of not being sick. It is based on a complex combination of environmental and social determinants, such as your physical and emotional health, your financial health, and your social connections. These determinants influence our health trajectories.


“Being a healthcare financier is a thing of the past. We want to be your health and wellness partner. Can we deliver value to you, without ever charging you? That’s a way to build trust.” Firdaus referring to the “freemium” model that tech companies such as Dropbox use to engage consumers and gradually earn their trust.


“Can we get to a place where consumers trust us with their data?” Firdaus asked. “We have to solve this problem. At Aeta we use artificial intelligence and machine learning to derive insights for Next Best Actions (NBAs) that target a member’s specific health profile. We then explain to consumers why they should take a specific action during their wellness journey.”

Firdaus described a research study commissioned by Aetna that shows that people who haven’t visited a primary care provider (PCP) in the past two years are five to eight times more likely to have an avoidable ER-related visit.

“We can show consumers how to use our digital tools to make an appointment, go see their PCP, and avoid the ER. It’s a win-win for everyone,” said Firdaus. “We did a pilot with a few thousand users where we actually demonstrated value to the user based on strong data science. It led to a 100% increase in visits to PCPs. Now we’re looking at the data to see how it decreased avoidable ER visits.”


“The purpose part is really important in healthcare. Tech people are in general very interested in, “How can I make this better?”” Firdaus describing why Aetna has brought on technical expertise to help solve healthcare problems. “We are the first to admit, we don’t know the future of healthcare. We can test and interate and hopefully have the courage to shut things down that don’t work.”


Read Prime Health’s interview with Firdaus for more insights into how healthcare companies are evolving to meet the needs of today’s heathcare consumers.