The relationship between payors and providers is changing rapidly. In the USA, Aetna has already moved to a partnership model in which large providers are paid on a per capita basis, rather than by activity. Meanwhile, new apps are creating a much more direct relationship between insurers and patients. These enable remote diagnosis and enables the payor to steer patients to the most suitable provider. Di Benedetto looks at these changes and at how Aetna plans to roll them out worldwide.