Aetna forms Northern California ACO

October 3, 2014 in Medical Technology

Hill Physicians Medical Group, Dignity Health Medical Foundation and Dignity Health hospitals have launched an accountable care initiative, introducing the Aetna Whole Health product, designed for businesses with employees who live in California’s Sacramento, San Joaquin, and Yolo Counties.

The insurance plan will be available in April 2015.

Through the ACO, Aetna members will receive an enhanced level of coordinated care in addition to the member benefits of their current Aetna plan, with access to more than 280 primary care physicians, 837 specialists, 37 hospitals and 14 urgent care facilities.

[See also: Bon Secours, Aetna ink big ACO deal.]

“Aetna is excited to collaborate with Hill Physicians and Dignity Health to transform patient care and build a more effective, sustainable healthcare delivery model in Northern California,” said Mark Reynolds, Aetna’s president for Northern California, in a news release. “Our accountable care agreement with these two organizations will ensure that our members receive the care that they need to help them live healthier, more productive lives.”

[See also: Aetna, Banner add power to ACO.]

As Aetna executives put it, the accountable care organization gives employers better healthcare options for their employees, and will feature a new model of healthcare delivery designed to offer:

  • Cost savings to employees who use providers in the accountable care network;
  • A more coordinated, personalized experience for patients; and
  • Better health care outcomes.

“In a marketplace as dynamic as ours, it’s important to be innovative,” said David Joyner, COO of Hill Physicians, in a press statement.

[See also: ACOs held back by poor interoperability.]

“We look forward to collaborating and coordinating to best serve the members who select it,” added Joe Jasser, MD, president and CEO of Dignity Health Medical Foundation.

[See also: They came to praise ACOs.]

The agreement features a new payment model to reward Hill Physicians and Dignity Health for meeting quality, efficiency and patient satisfaction measures, including:

  • The percentage of Aetna members who get recommended preventive care and screenings;
  • Better management of patients with chronic conditions, such as diabetes and heart failure;
  • Reductions in avoidable hospital readmission rates; and
  • Reductions in emergency room visits.

Dignity Health, one of the nation’s six largest health care systems, is a 21-state network of nearly 9,000 physicians, 55,000 employees, and more than 380 care centers. Hill Physicians Medical Group is the largest independent physician association in California.

Aetna is working with healthcare organizations across the country to develop products and services that support value-driven, patient-centered care for all health care consumers. Nationally, more than 2.3 million Aetna members are served by value-based health care models.

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Article source: http://www.healthcareitnews.com/news/aetna-forms-northern-california-aco

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