SANTA ANA, Calif. – Aetna (NYSE: AET) has introduced the regional Aetna Whole Health – Southern California plan to employers with employees in San Diego County, Orange County, Los Angeles County and select portions of the Inland Empire.
The new, regional health care solution includes the networks of four existing accountable care collaborations — Aetna Whole Health – Sharp in San Diego; Aetna Whole Health – MemorialCare in Orange County and southern Los Angeles County; Aetna Whole Health – PrimeCare Physicians Plans in the Inland Empire and Aetna Whole Health – Providence Health & Services in Los Angeles County — to improve access, quality and affordability for Aetna customers and members. The four Aetna Whole Health plans will continue to be available on an individual basis for local employers that don't have need for a network that covers a broader geography.
Aetna Whole Health – Southern California members will have access to approximately 1,400 primary care doctors, 8,300 specialists, 51 hospitals and 122 urgent care facilities across five counties. The new plan is currently available for self-insured employers and will be available to fully insured employers pending regulatory approval.
"We are excited to expand our relationships with Sharp, MemorialCare, PrimeCare and Providence to offer a regional health care product for our members and customers in Southern California," said Kristen Miranda, Aetna's president in California. "This innovative product brings together the right doctors, facilities and technology to improve health outcomes, while enhancing the member experience."
Aetna Whole Health gives employers better health care options for their employees, and will feature a new model of health care delivery designed to offer:
- Cost savings to employees who use providers in their selected network;
- A more coordinated, personalized experience for patients; and
- Better health care outcomes.
"As the region's leader in delivering high-quality care and a superb patient experience at a reduced cost, MemorialCare is honored to be Aetna's exclusive network partner in Orange County, Southern Los Angeles County and Greater Long Beach," says Barry Arbuckle, Ph.D., MemorialCare President & CEO. "Employers and patients seek our innovative offerings because we tailor programs to meet their needs, use data to improve outcomes and help those with risk factors manage chronic conditions and achieve optimal health. With hospitals and 200 care locations, we are able to provide consumers, employers and health plans high value care in the right location with the right services and at the right price."
New payment agreements reward improvements in quality and costs of care
The agreement features a new payment model to reward providers for meeting quality, efficiency and patient satisfaction measures including:
- The percentage of Aetna members who get 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 emergency room visits.
"With Aetna Whole Health we are building upon our long-standing partnership with Aetna to provide people living in the Inland Empire access to high-quality, cost-effective care," said Jamie Phillips, president of PrimeCare.
"Our goal is to improve access to top-quality, affordable health care here in the Los Angeles Area – from the South Bay to the San Fernando Valley and beyond – while continuously raising the bar on patient satisfaction," said David Mast, CEO of Providence Health & Services Los Angeles medical foundations. "We can best meet this goal by collaborating with physicians, hospitals and payers to ensure high value care is available to the communities we serve."
"Sharp HealthCare and our medical groups, Sharp Community Medical Group and Sharp Rees-Stealy Medical Group, are very excited to be part of this Southern California offering and to be aligned with Aetna and these other excellent providers," said Mike Murphy, President and CEO of Sharp HealthCare, San Diego's largest health system. "Employers here in San Diego and throughout Southern California can provide value to their workers by offering a collaborative network that ensures the delivery of high-quality, cost-efficient care."
Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. Nationally today, more than 7 million Aetna members receive care from doctors committed to the value-based approach, with approximately 53 percent of Aetna claims payments going to doctors and providers who practice value-based care.
Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 40.3 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 and behavioral health plans, 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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