The Health Section

Aetna’s outreach to tackle antibiotic resistant bacteria

Continuing its provider outreach initiative, Aetna sent more than 1,100 letters to clinicians in the United States, who prescribed antibiotics to treat an acute bronchitis diagnosis.


Color shows average fail rate per state. Number (on state) shows count of providers within the state. The data is filtered on three criteria: provider must be a key specialty, provider must have at least five members and the state must have at least five providers.


After analyzing claims data from 2015 and working with the U.S. Centers for Disease Control and Prevention (CDC), Aetna identified 1,115 clinicians who diagnosed five or more patients with acute bronchitis and prescribed antibiotics as treatment at least 50 percent of the time. CDC guidelines recommend against prescribing antibiotics to treat acute bronchitis because it’s caused by a viral infection. Antibiotics are used to treat and prevent bacterial infections. The clinicians included family physicians, internists, nurse practitioners and physician assistants.

“Appropriate prescribing of antibiotics is imperative to preventing the emergence and spread of superbugs,” said Harold L. Paz, M.D., M.S., executive vice president and Aetna’s chief medical officer. “Reaching out and reminding doctors of evidence-based treatment practices for acute bronchitis will keep patients and families healthy in the long run.”


Harold L. Paz, M.D., M.S., executive vice president and chief medical officer for Aetna, signs a letter sent to a clinician for over-prescribing antibiotics. | Eric Vo


The overuse of antibiotics is accelerating the creation and spread of resistant bacteria. Over 30 percent of antibiotic prescriptions written in an outpatient care setting in the U.S. from 2010 to 2011 were prescribed unnecessarily, according to a study published in the Journal of the American Medical Association.

The 1,115 clinicians received a letter signed by Paz, which contained the CDC’s guidance on “Avoidance of Antibiotic Prescribing for Acute Bronchitis.”

In addition, Aetna sent 127 letters thanking clinicians who followed proper treatment guidelines and did not prescribe antibiotics to treat acute bronchitis for any of their patients.

The letters are a continuation of the “super-prescriber” initiative Aetna launched in 2016, on the premise that clinicians are data-driven and want to conform with evidence-based best practices. This program started with a campaign to battle the opioid epidemic. At that time, Aetna sent letters to over 1,000 doctors that were identified as prescribing opioids at a higher rate than their peers.

And in May 2017, the company sent letters to hundreds of dentists and oral surgeons, who were also identified as “super-prescribers” of opioids. Aetna continues to look for ways to use our data analytics capabilities to help clinicians serve their patients.