NEW YORK – Aetna (NYSE: AET) and NYUPN Clinically Integrated Network, LLC (NYUPN) today announced an accountable care collaboration that is designed to improve patient care and lower health care costs. Effective July 1, NYUPN and its more than 1,800 clinical faculty and health care professionals affiliated with NYU Langone Medical Center and University Physicians Network (UPN) began working more closely with Aetna to ensure improved care coordination and care quality. Aetna will financially reward NYUPN for quality health outcomes for approximately 24,000 members in both commercial and Medicare Advantage plans.
"Consumers belong at the center of a health care system that promotes wellness, provides better care for chronic conditions and uses economic incentives to reward positive health outcomes," said David Kobus, Aetna senior vice president, New York Network. "When health care providers and health plans work together, care improves for the people we serve. This new collaboration with NYUPN will provide their physicians with useful information that will support more patient outreach, better care coordination and a health care experience that is simpler and more effective."
Under the new collaboration agreement for commercial members, Aetna will reward NYUPN and its physicians for quality and efficiency improvements such as:
- The percentage of Aetna members who receive recommended preventive care and recommended services such as breast, colorectal and cervical cancer screenings;
- Better management of patients with diabetes, including lipid and HbA1C screenings and retinal exams and nephropathy treatment ; and,
- Appropriate treatment for children with upper respiratory infections.
Aetna will also help defray NYUPN's costs for care coordination personnel and health information technology that will benefit Aetna members.
Under the Medicare collaboration, quality and efficiency measures will also be tracked and shared savings will reward NYUPN physicians for meeting measures such as:
- The percentage of Aetna members receiving recommended preventive care and screenings; and
- Better management of patients with chronic conditions, such as diabetes and heart failure.
"Care coordination and collaboration is particularly important for our Medicare Advantage members," said Terry Golash, M.D., senior medical director, Aetna, New York. "Many Medicare members have complex health care needs that go undetected. When care providers and insurers work together in a Medicare collaboration model, information and resources can be shared to improve care and direct outreach."
Similar to other Medicare collaborations in place in New York and elsewhere, Aetna nurse case managers will work closely with NYUPN physicians to identify, coordinate and improve the care of these members and ensure adherence to best practices and treatment plans.
In a study published in Health Affairs, an Aetna Medicare Provider Collaboration program:
- Significantly reduced hospital admissions and readmissions;
- Increased preventive care; and
- Reduced health care costs for the study population compared to unmanaged Medicare.
Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care for all health care consumers. Presently in New York, Aetna has nearly 100,000 members served through value-based collaborative arrangements, with the intent to reach 200,000 – or approximately 20 percent of its membership – by year-end. Nationally, more than 1.5 million members are served by this health care model.
About NYUPN Clinically Integrated Network
NYUPN is the clinically integrated network (CIN) of University Physicians Network (UPN) and NYU Langone Medical Center (NYU Langone). This unique alignment brings together over 1,800 physicians of the UPN and NYU Langone hospitals to collaborate in implementing nationally recognized standards for patient-centered, high quality, cost-efficient healthcare delivery. All physicians and hospitals use electronic medical records (EMR) that are connected to a network wide health information exchange (HIE), facilitating timely exchange of clinical information. NYUPN will also serve as a vehicle to negotiate and successfully execute health care contracts based on new and emerging payment models that reward high quality and cost-efficient care.
Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 45 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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