PHILADELPHIA – Aetna (NYSE: AET) and The Children's Hospital of Philadelphia (CHOP) today announced a new accountable care organization (ACO) collaboration designed to improve the quality of care and lower health care costs through more coordinated care. This is Aetna's first pediatric ACO arrangement.
Under the contract, members of Aetna commercial plans (up to age 19) in the five-county Philadelphia area and Burlington County, N.J., and who receive care from CHOP physicians, became part of the program.
The agreement is part of Aetna's strategy to transition from fee-for-service reimbursement to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, reduce duplication of services, improve health outcomes, and make it easier for people to get the care they need. In value-based models, doctors and hospitals are paid for helping keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.
"The Children's Hospital of Philadelphia is committed to exploring new and innovative relationships that enable families throughout our service area to benefit from the world-class pediatric care that they can only receive at CHOP," said Matthew Cook, executive vice president of strategic planning and business development, at The Children's Hospital of Philadelphia. "This agreement with Aetna will be of great benefit to their subscriber families and we are gratified to join Aetna in this effort."
"Aetna is engaging in hospital collaborations that promote coordinated, high-quality care, and an improved patient experience at lower costs," said Laurie Brubaker, president of Aetna's Pennsylvania operations. "We're delighted to work with CHOP to achieve those goals for our members in the Philadelphia area."
The agreement features a new payment model that rewards physicians for meeting certain measures designed to improve quality, lower costs and improve patient satisfaction. Examples include reducing potentially avoidable hospital admissions and emergency-room visits, and improving appropriate antibiotic usage. More than 1,100 CHOP physicians will be part of this new model. Aetna provides health benefits to nearly 1.4 million members in Pennsylvania.
About The Children's Hospital of Philadelphia
The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. In addition, its unique family-centered care and public service programs have brought the 535-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit www.chop.edu.
Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.5 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.
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