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(originally published by Booz & Company)


Global Lessons for Controlling Healthcare Costs

Like many private insurers, U.S.-based Aetna Inc. has used health plans for expatriates as a platform for international expansion. Aetna Global Benefits (AGB) provides health coverage for more than 325,000 expatriates, third-country nationals, and key local nationals in more than 100 countries. In 2008, AGB established an office in Shanghai, its first step into China’s growing medical insurance market.

Aetna is also leveraging its capabilities overseas. Its U.K. subsidiary, Aetna Health Services, provides care-management and demand-management services, as well as information services, such as data management, needs analysis, predictive modeling, and clinical decision support technologies. In January 2011, the subsidiary won an award from the British magazine Health Service Journal for its role in a chronic care program involving primary care doctors in the West Midlands that reduced the hospital admissions among participating patients by 45 percent.

UnitedHealth International (UHI), the global arm of U.S.-based UnitedHealth Group, offers Global Choice, a comprehensive health plan developed by British insurer BUPA International. BUPA is the largest player in the expatriate market, insuring more than 8 million expatriates in 190 countries.

UHI also partners with selected players in other countries to help them improve care and reduce costs by blending local needs with lessons learned from the U.S. healthcare industry. For example, since 2004, UHI has been working with the U.K.’s National Health Service to implement its Evercare program, a U.S. model that uses proactive care delivered by nurses to keep older people healthy and out of hospitals.

In and of themselves, treatment guidelines, direct reference, and direct investment by payors will not solve all the problems of failing or inefficient healthcare systems. But it is clear that the payors and the healthcare systems they operate within can benefit from a more global approach to solving their problems and securing their future. Just as consumer and industrial companies can achieve better results by taking a broad-based approach to generating new product ideas, healthcare payors have a far better chance of developing more effective medical management strategies if they cast a wider net. They won’t pull in winning ideas with every cast, but they will certainly have better catches than payors who fish in only one pond.

Author Profiles:

  • Peter Behner is a partner with Booz & Company and the firm’s European health practice leader. Based in Berlin, he focuses on growth strategies, distribution channel management, and logistics optimization in the pharmaceutical industry.
  • Rick Edmunds is a senior partner and global health practice leader for Booz & Company in Washington, D.C. His focus is corporate and commercial strategies for life science companies and U.S. payors.
  • Elizabeth Powers is a principal in Booz & Company’s healthcare practice in New York, specializing in pharmaceutical commercial strategy.
  • Also contributing to this article was Booz & Company senior associate Nelia McGreevy.
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