Mark Bertolini Aetna CEO Mark Bertolini testifies on Capitol Hill in Washington, before the House Judiciary Committee hearing: "Healthy Competition? An Examination of the Proposed Health Insurance Mergers and the Consequent Impact on CompetitionHealth Insurance Merger, Washington, USA

Mark Bertolini used to think he had all the answers. After all, the former chief executive of health insurance giant Aetna was Ivy League-educated, graduated top of his class in finance and had proven himself over time as a serious player in the business world.

For him, it was just a matter of playing a waiting game until all of his coworkers and subordinates came to the natural conclusion that he was right.

“I would play these mental games in my head where I would say ‘OK, what kind of questions can I ask these people to come to the answer that I already know is the right one’ and I would get frustrated,” he told WWD.

Bertolini worked this way for years until he had a rude awakening when his boss at the time suggested it might be beneficial for him to actually listen to opposing views before getting frustrated and then formulate a few questions as a result of those answers and get even better information.

While it doesn’t sound like much of a stretch, this one suggestion turned his view of leadership on its head and triggered him to slowly change the way he worked, moving further and further from the top-down level of authority he had diligently followed as he climbed up the career ladder.

“I went from a person who, 100 percent of the time, thought I had all the right answers to a person who knows that probably only 40 percent of the time do I have the right answers and they’re probably not totally well-formed anyway,” he said. “What I learned over that time is it’s better not to have all the answers.”

This is the mantra through which he ran Aetna as chief executive officer from 2010 to 2018, when it was acquired by CVS for close to $70 billion, as detailed in his new book “Mission-Driven Leadership: My Journey as a Radical Capitalist.”

Bertolini took a leap of faith to trust Aetna’s frontline workers, who receive around 20,000 calls per hour, giving them more responsibility to make decisions so they could respond quickly and efficiently to customers despite facing pushback from several of hi executives.

He also realized that in some cases, the only way Aetna could design the right policies was by trusting people on the ground who understood the issues, such as the needs of one city looking nothing like the needs of another. That was particularly the case in parts of Appalachia, which have been devastated by opioids.

“The old management model — in which you follow the rules, curb your individuality, and get your paycheck — no longer works. We don’t have a talent problem in this country. We have a corporate culture problem that prizes obedience over creativity and repetition over fulfillment, and our workforce, particularly Millennials, raised in the digital age, will no longer accept that. What they will accept is the trust model,” he wrote in his book.

“My goal is to stand back and let the company work, and that’s hard for operators like me. But I’ve reached the point where I’m ready to stop requiring many of the traditional oversight tasks, even reviewing expense reports.”

That’s not to say mistakes weren’t and won’t be made along the road, but according to Bertolini, it’s all part of the process. He even let some of his senior staff launch a product that he knew would struggle. When it did, the company took a $40 million charge.

He let them do it because he thought it was important for them to learn from their own mistakes. They subsequently fixed it, creating an improved product, which is now one of the company’s best-sellers. As a result of this experiment, Aetna sets aside about $300 million each year as a contingency for just those kinds of setbacks.

“I know I can fix a problem in five minutes. It’s not because I’m smarter. It’s because I’ve been through it — but now the organization has to learn so other leaders can absorb the lessons and pass them on to the next generation,” he wrote.

“In placing greater trust in executives or managers, I’m not suggesting that the inmates run the asylum. I get heavily involved on specific problems when I have to. Trust is essential, but so too are verification, controls, a strong senior team and vigilance.”

With the United States’ unemployment rate hovering at an extremely tight 3.7 percent, Bertolini believes trusting your staff is more important than ever when they have so many options of where to work.

“You need to treat employees a lot differently. You need to make them feel like they’re a part of a growing and thriving organization, and that’s the balance we’ve missed is that shift as business leaders,” he said.

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