–Serving more than 16,000 members in Camden, Burlington and Gloucester counties–
PARSIPPANY, N.J.–(BUSINESS WIRE)–Aetna (NYSE: AET) and the Virtua Medical Group (VMG) today announced a new accountable care agreement that will expand on an existing Medicare Collaboration already serving an estimated 2,000 Aetna Medicare Advantage Members since July 2012. The new accountable care agreement is designed to improve the coordination and delivery of patient care and provide a better patient experience for more than 16,000 Aetna commercial members in Camden, Burlington and Gloucester counties.
The VMG primary care practices include more than 95 physicians and other care providers. The practices are recognized as Patient-Centered Medical Homes by the National Committee for Quality Assurance. The VMG primary care practitioners are supported by Virtua Medical Group and Virtua Surgical Group specialty physicians as well as by a large hospital network including Virtua Memorial Hospital, Virtua Marlton Hospital and Virtua Voorhees Hospital.
Aetna members who receive care from VMG primary care physicians will be served under this new agreement. VMG will be accountable for cost, quality and patient satisfaction for the health care they provide. Aetna nurse case managers will work with physicians and the hospitals to assist in care coordination, outreach and follow-up services for Aetna members.
Aetna members served under this agreement will experience more highly coordinated care, particularly for those patients with chronic or complex conditions. They also will have enhanced access to appropriate care and will benefit from the improved flow of information to VMG physicians who provide treatment.
“We are delighted to expand our existing Medicare Collaboration with Virtua under this new agreement, and to bring the benefits of this value-based model of care to our members in southern New Jersey and southeastern Pennsylvania. We look forward to expanding our agreement even further over the coming months,” said John Lawrence, president, Aetna – New Jersey. “This agreement aligns with the federal government’s recently announced goal of expanding value-based agreements to more people over the next several years.
“Aetna will work closely with the VMG physicians to identify specific areas where we can either develop or improve on the sharing of specific, useful health information. In turn, the physicians will use this information to improve care for patients, close gaps in care and reduce waste. We are creating a continuous loop of improved information to drive better care. Working together, we aim to bring better health, better care and lower costs to thousands of Aetna members.”
“Virtua and Aetna share a common vision for providing a continuum of care for our patients in a value-based delivery model that emphasizes clinical excellence and effectiveness, coordinated access, and excellent customer service,” said Richard P. Miller, Virtua President and CEO. “Our expanded relationship with Aetna is a demonstration of our overall mission to help patients be well, get well and stay well.”
Aetna members who have been treated by VMG affiliated physicians over the last 24 months will be covered by this agreement. Their benefits will not change, but those members will be part of a select group that will receive highly coordinated, personalized care. The agreement went into effect on January 1, 2015 for fully-insured customers and will be effective May 1, 2015, for self-insured customers.
The careful tracking of quality metrics is a critical part of why accountable care organizations are successful at improving patient care and are fundamental to the incentive structure. This agreement includes a shared savings model that rewards Virtua physicians for meeting certain quality and efficiency measures such as:
- The percentage of Aetna members who receive 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 unnecessary emergency room visits.
Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for all health care consumers. Nationally today, about 3.2 million Aetna members receive care from doctors committed to the value-based approach, with 28 percent of Aetna claims payments go to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 50 percent by 2018 and 75 percent by 2020. In New Jersey, Aetna has nearly 230,000 members or 21 percent of its members served through value-based collaborative arrangements, including ACOs, with the intent to reach over 400,000 or 35% of its members during 2015.
Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @aetna
As one of New Jersey’s largest health systems, Virtua helps people be well, get well and stay well through a comprehensive range of health care services. Services are delivered through three health and wellness centers, three fitness centers, three acute care hospitals, primary and specialty physician practices with more than 240 physicians, urgent care centers, nine ambulatory surgery centers, home health services, two long-term care and rehabilitation centers, 12 paramedic units and a wide range of outpatient services. A leader in maternal and child health services, Virtua delivers more than 8,000 babies a year. Virtua also provides employment and wellness services to 1,700 businesses and corporations. An innovator in clinical and information technology such as electronic medical records, Virtua is recognized for its ground-breaking partnerships with GE Healthcare, Children’s Hospital of Philadelphia (CHOP) and the Fox Chase Cancer Center. Virtua employs more than 8,700 people and has been honored as the #1 Best Place to Work in the Delaware Valley every year since 2007. It is the recipient of the Consumer Choice Award from the National Research Corporation. For more information, visit www.virtua.org or www.virtuabroadcastnetwork.org.