Aetna Cuts 4 New Accountable Care Deals

The launch of an accountable care health plan product in Washington State includes new partnerships between Aetna and four healthcare provider organizations.

With four new pacts announced last week, Aetna is continuing its nationwide push to rack up commercial accountable care collaborations with healthcare providers.

As part of the Hartford, CT-based insurer's launch of its Aetna Whole Health health plan in Washington State, the insurer has inked accountable care collaboration agreements with Pacific Medical Centers, The Polyclinic, Providence-Swedish Health Alliance, and Rainier Health Network.

Norman Seabrooks, Aetna's northwest market president, says the pacts raise the tally of the insurer's accountable care collaborations to 51.

"Aetna believes that healthcare is moving in a direction where collaboration and innovation are vital to improving the quality, value, and efficiency of care while providing a better overall patient experience. To that end, we are working with healthcare providers and organizations across the country, including the four provider groups in the Puget Sound region, to create a more sustainable healthcare model that will move the needle on improving outcomes while controlling costs," he said.

Seabrooks says the collaborations will target the group health insurance market. "The Aetna Whole Health plan… will allow our customers who purchase the plan to offer their employees enhanced, coordinated care through four distinct and robust networks… This means that employees will be able to choose where they get care based on their personal and geographic preferences," he said.

"We anticipate that this new product will save participating [employers] between 7 and 12% on medical costs in the first year," Seabrooks said. "There is a shared-risk agreement with each of the four networks that rewards them for reducing medical costs and improving the quality of care provided."

'Aligns Our Interests'
The top executives of Aetna's new Washington State partners are bullish on the accountable care collaboration.

"One of the strongest features of the Aetna Whole Health product for the Rainier Health Network is the benefit design for enrollees," says Rainer CEO Rick MacCornack, PhD. "The plan provides a financial incentive to establish a lasting relationship with a primary care provider, which is the basis in trying to provide more value and better health for plan participants. This feature enhances our network's ability to provide continuity of care and better coordination of patient care for most, if not all, of the services provided by Rainier Health Network."

Lloyd David, MBA, The Polyclinic's CEO, says the Aetna pact is a win-win for his organization and its patients. "We have full confidence in our ability to deliver healthcare efficiently and cost effectively, and this partnership with Aetna Whole Health allows us to demonstrate our strengths and be rewarded for our performance."

"When patients make a choice to get their care from The Polyclinic network, they establish a stronger relationship with us, which opens the door for us to reach out to engage and coach them more vigorously. And our contract aligns our interests with the patient and the purchaser by creating rewards for increasing quality and managing the total cost of care."

Provider Network Perspective
Aetna's new partners says the accountable care collaboration will deliver value to health plan members in provider networks that are more than adequate in terms of geography and quality.

The CEO of Providence-Swedish Health Alliance, Joe Gifford, MD, highlighted his organization's provider network. "[It] is a network with boundaries, but it's anything but narrow," he says.

"With six hospitals in King and Snohomish counties, 80 clinic locations, and over 1,500 physicians, Providence and Swedish offer comprehensive care. We offer access to a wide range of specialists and sub-specialists, and are well prepared to meet virtually any medical need. To receive the maximum benefit, members must seek care through Providence-Swedish Health Alliance providers, clinics, walk-in clinics and hospitals. Seeking care within our network helps enable our goal to achieve the 'triple aim:' lower cost, better population health and better quality."

MacCornack said Aetna has created the equivalent of a broad network in the Puget Sound region. "Rainier Health Network consists of nearly one thousand providers representing fifty-five medical specialties. Geographically, we have providers in South King, Pierce, Kitsap and Thurston counties. We would not consider this to be a narrow network, especially since Aetna Whole Health also includes health care systems that cover King and Snohomish counties," he said.

Accountable Care Deal Goals
All four healthcare provider CEOs say they have lofty goals for their new relationship with Aetna.

Gifford says Providence-Swedish Health Alliance is hoping to hit three targets:

• Improving medical care for members with chronic conditions;
• Providing patients with "top-notch member experiences," including greater access to healthcare providers; and
• Making sure patients get "appropriate and necessary care they need when they need it."

David says The Polyclinic is primed to succeed. "Our goal as an Aetna Whole Health provider is to use our years of experience in full-risk and shared savings contracts to provide patients with high-quality, personalized care, and to offer employers a cost-effective product that helps them reduce their insurance costs and better manage their bottom line," he says. "Delivering great value should enable us to continue to grow and increase market share."

Vik Dabhi, MD, PhD, chief medical officer of Pacific Medical Centers, says the accountable care pact with Aetna is a golden opportunity.
"We have shifted our perspective to focus on prevention and health, and PacMed's approach to care works to reduce cost and improve the health of our patients. With products like Aetna Whole Health, we can change the way healthcare is organized, delivered and paid for, and provide our patients with exceptional quality, producing excellent outcomes and high patient satisfaction with lower costs."