RALEIGH, N.C. – Aetna and Community Care of North Carolina. Inc. (CCNC) today announced a new agreement to combine Aetna’s expertise in Medicaid managed health care services with CCNC’s medical home and care management services, Community Care Physician Network, LLC (CCPN), and Community Pharmacy Enhanced Services Network (CPESN) USA.
A Request for Proposal (RFP) is expected to be released as early as spring 2018 by the North Carolina Department of Health and Human Services as the state works to transform the state Medicaid and North Carolina Health Choice programs to a managed care system. Aetna will participate in the RFP.
In this value-based agreement, CCNC will perform care management and coordination services for Aetna. Aetna’s Medicaid members will have full access to the vast array of network providers in the CCPN.
This unique delivery model will allow Aetna, CCNC, CCPN and CPESN Networks to provide enhanced services and will support complex patients with medication use support, care management and coordination of community services to address social determinants of health.
“We are excited about our collaboration with Aetna as it allows us to blend the best of both organizations to create a best in class service delivery model that will further improve outcomes for Medicaid recipients,” said L. Allen Dobson, Jr., MD, president and CEO of Community Care of North Carolina. “Both Aetna and CCNC understand that local, community-embedded health professionals and a national carrier working together can help North Carolinians live healthier lives. CCNC is ready to partner with Aetna, a health plan committed to improving quality and access to care and to build on CCNC’s strong provider infrastructure.”
“This agreement aligns with the changes taking place in health care right now both in North Carolina and nationwide,” said Laurie Brubaker, president and CEO of Aetna Medicaid. ”We look forward to working with CCPN, CCNC and CPESN to develop an integrated health care delivery system that builds on existing care management programs, provides a holistic approach to health and expands the provider/payer collaborative to improve health for the Medicaid and North Carolina Health Choice populations.”
Additionally, Aetna and CCNC will collaborate to develop a physician-driven, patient-focused approach that will transform the way health care services are provided statewide, with the unique ability to support health in rural communities. The agreement builds on an existing relationship between the organizations that focuses on developing innovative ways to deliver health care to Aetna’s Medicare Advantage members in rural areas of North Carolina.
Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 44.6 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.
CCNC is a national leader in transforming health care, joining community-based care managers with local primary care physicians and diverse teams of health professionals to develop whole-person plans of care. Informed by statewide data and predictive analytics, the CCNC program builds patient-centered practice models, connects people to the right local resources, and leads collaborations with health systems and public health. This proven population health management approach delivers better health outcomes at lower costs. For more information, visit https://www.communitycarenc.org.
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