It’s no secret that there’s been much discussion about the uneven adoption of digital health tools that drive measurable outcomes for consumers. Last week, Aetna made news by announcing Attain, an app co-developed with Apple that will track and reward consumers for maintaining a healthy lifestyle. The app’s launch included a microsite replete with sleek imaging and several use cases that, perhaps unsurprisingly, have a similar design to Apple’s standard Health app.


Other health plans have similar programs for commercial and individual populations alike that include gamification and incentives to encourage healthy behaviors. However, Attain has some distinguishing features that could showcase what an integrated Aetna-CVS can do for consumers. For example, the app goes beyond standard tracking activities and includes support for more serious health moments, including info on nearby labs, pharmacies and PCPs. The app also boasts personalized recommendations and reminders to help consumers spot money-saving opportunities (cheaper clinics or screening locations, for example) and navigate to them via an integrated map. I can see how this can very clearly steer Aetna’s members to the expanded CVS health hubs in the future.


However, I was a bit surprised by some of the details in the initial launch. For instance, Aetna is targeting its commercial plan members, or those who have Aetna insurance through their employers, to start. I found this a bit counterintuitive because almost 80% of Aetna’s commercial membership belongs to self-insured employers. Therefore, Aetna does not directly benefit from medical cost savings for a large chunk of its commercial business.


Regardless, I can see Attain creating value for Aetna in a few ways:

  • Becoming a selling point to the HR decision maker by letting the employer lower its costs by helping consumers navigate to the cheapest services and providers. These savings also could be passed to the end consumer.
  • Helping Aetna drive simple interventions at scale, especially for the 20% of commercial membership that Aetna fully insures. These are mostly small businesses (think 100 or fewer employees).
  • Using this as a tool to retain employers with Aetna by demonstrating that strong adoption can drive medical savings and lead to a happier and more productive workforce

If one or a combination of the above come to fruition, then Aetna should be well positioned to gain value from the app. But that’s a big if, and the word that comes to mind for me whenever I hear about new digital health tools is the word I used earlier: adoption.


This brings me to the second surprise from the launch: Aetna starting with an invite only group. It makes sense to start small with something this ambitious. The exclusiveness is nice to attract some buzz, but I wonder about this. The people who clamor to sign up will likely be—to borrow some phrases from a colleague—the health nuts rather than the health nots. Further, they also could belong to a specific demographic or employer groups that may not represent the needs or behaviors of the broader population. Perhaps this is simply a beta test to ensure viability rather than a rigorously designed experiment to demonstrate outcomes. A much broader implication for this partnership with Apple pertains to data. How will users of Attain think about their personal data and how it’s used? With all the talk about health data these days, will consumers be OK knowing that their personal health information, behaviors, and every click will be integrated into Aetna’s broader data sets on members (or shared with the employer or Apple in a de-identified manner)?