Aetna Introduces a New, Zero-premium Medicare Advantage Plan Through PinnacleHealth System

Monday, October 6, 2014

The “Aetna PinnacleHealth Prime Plan” offers access to high-quality, coordinated care

HARRISBURG, Pa., — Aetna (NYSE: AET) today announced a new $0 premium Medicare Advantage plan that will be available during open enrollment this fall for January 2015 effective dates in Cumberland and Dauphin counties of Pennsylvania. The Aetna PinnacleHealth Prime Plan is a Medicare Advantage HMO based on an accountable care agreement with PinnacleHealth System and its affiliated physicians and other health care providers.

PinnacleHealth’s comprehensive, integrated system of physicians, hospitals and ambulatory services will coordinate care to provide high quality, efficient, convenient and affordable care to Medicare beneficiaries and work to provide better health care by:

  • Creating a more coordinated patient experience;
  • Providing members with predictable costs when they use doctors and other health care providers in the Aetna PinnacleHealth Prime Plan network; and
  • Improving health care outcomes.

“We are pleased to offer Medicare beneficiaries a new zero-premium plan that emphasizes care coordination and collaboration,” said Laurie Brubaker, Aetna’s president for Pennsylvania. “PinnacleHealth doctors and health care professionals will work closely with us to help provide each member with a top quality, personalized health care experience, without having to pay a monthly plan premium, which is an incredible value.”

The agreement between PinnacleHealth System and Aetna aligns financial incentives around preventive care, chronic condition management, and a focus on member well-being. This new Medicare Advantage plan expands upon Aetna’s previously announced Accountable Care Organization agreement with PinnacleHealth to serve Aetna’s commercial plan members.

“PinnacleHealth delivers coordinated, nationally recognized quality care that helps our patients live healthier lives,” said Michael A. Young, president and CEO of PinnacleHealth System. “This collaboration with Aetna allows us to provide a strong network for the PinnacleHealth Prime Plan, which will offer choice, flexibility and access to Medicare patients in Cumberland and Dauphin counties.”

Accountable care models drive focus on more coordinated care

Accountable Care Organizations are alliances of physicians, hospitals and other providers that coordinate care for their patients. In an ACO, providers assume responsibility for improving the quality of patient care and lowering costs through better coordination and preventive care. Aetna members in these plans will receive an enhanced level of coordinated care.

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. Nationally, more than 2.3 million Aetna members are served by value-based health care models.