The Aetna Cure - 'ZIFFPAGE TITLEAetna Base Case ' (
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Aetna Base Case
Headquarters: 151 Farmington Ave., Hartford, CT 06156
Phone: (860) 273-0123
Business: Health benefits, including managed care.
Chief Information Officer: Weh-Tih Cheng
Financials in 2003: $17.9 billion in revenue; profit of $933.8 million; net profit margin 5.2%.
Challenges: Complete the turnaround begun in 2002 by unifying claims systems, improving the accuracy of plan pricing and building profitable growth.
Baseline Goals (Revisited): Here are the Aetna goals outlined in Baseline's August 2002 case study, compared with the results:
Goals
Reach operating margin of 6% of revenue by end of 2003.
Increase portion of electronic claims from about 50% to 85%.
Increase auto-adjudication of e-claims, from 62.1% to 70%.
Create "paperless" enrollment, claims checking by late 2002.
Results
Done. Reached 9.3% for third quarter, 2004.
Not quite. The rate hit 83% for the third quarter, 2004.
Done. The rate rose to 73.9% for the third quarter, 2004.
Done. Aetna says many large plan sponsors forgo paper.
Projects: Processes 
