Transitioning away from a fee-for-service model, Aetna is partnering with providers across the United States on joint ventures to deliver more affordable and better health care to consumers and employers. As a value-based care model, joint ventures will reward physicians within their networks for better patient outcomes.
“People often feel frustrated and confused by what they experience in health care today,” said Brigitte Nettesheim, vice president of Transformative Markets at Aetna. “Joint ventures include partners working together to change the system by focusing on patient care and satisfaction and fully aligning the incentives of providers and health plans.”
Editor’s note: Thomas J. Grote was named the CEO of the Banner|Aetna joint venture in May 2017.
Aetna has more than 1,700 value-based contracts in 36 states.
More than 6 million Aetna members receive health care in a value-based model.
Value-based care helping achieve better patient outcomes
To date, Aetna has four joint ventures with networks in Arizona, Minnesota, Texas and Virginia.
The partnerships are a part of Aetna’s “Vision 2020” strategy, which seeks to ensure 75 percent of Aetna’s contracts are in value-based care models within the next four years. Over 45 percent of claim payments currently go to providers who deliver value-based care.
“Joint ventures are the most effective model for providing care to patients in their local communities,” Nettesheim said. “These partnerships are designed to offer patients personalized care at each touch point of their health care journey.”
Sharing resources to help patients
A joint venture is a mutually beneficial collaboration between Aetna and a health system. The health system provides its network of providers and care settings, such as hospitals and clinics. Aetna provides its health plan expertise, cutting-edge analytics and health information technology.
The result? Patients benefit from a more affordable, streamlined and coordinated health care experience.
In 2013, Aetna partnered with Inova Health in Northern Virginia to create Innovation Health.
One of the first partnerships of its kind between a payer and health system, the company now has more than 189,000 individual members and 1,700 business members.
Since launching Innovation Health, members have experienced significant, measurable improvements in quality of care, outcomes and low overall cost of care. For example, admissions for C-sections have decreased by 31 percent over the past two years. Avoidable surgical admissions are also down 13 percent from 2014 to 2015 and the generic prescribing rate increased by 15 percent.
Aetna’s second joint venture was signed in 2016, when Aetna partnered with Texas Health Resources in Dallas-Fort Worth. It focuses on using data to identify at-risk patients and get them into care earlier before problems occur. It’s also seeking to expand access to alternative sites of care and use advanced population health technology to help members manage chronic and other health conditions.
In October 2016, Aetna and Banner Health created “Banner|Aetna,” which will provide affordable, high quality care to people and employers in the Phoenix, Arizona, area. Focused on enhanced consumer experience, the partnership will offer a neighborhood care model. It will also feature a technology platform that offers one place to access both insurance and health care information.
Aetna has an existing five-year accountable care relationship with Banner, called “Aetna Whole Health – Banner Health Network.” The accountable care organization has led to several improvements:
- 24 percent decrease in surgery admissions
- 4 percent increase in generic prescribing
- 5 percent overall reduction in medical costs (vs. expected costs for the market)
- More than $2.6 million in final fully insured savings for 2015.
Most recently, Aetna partnered with Allina Health to create Allina Health Aetna. With over 4,000 physicians in the Allina Integrated Medical Network, the joint venture will offer members access to high-quality, cost-effective care.
And as part of its Vision 2020 mission, Aetna will continue to work to create new partnerships with health systems to help members across the country.