HARTFORD, Conn. – Aetna (NYSE: AET) has worked with health care organizations nationwide since 2011 to develop products and services that support value-driven, patient-centered care for consumers and also help reduce health care costs. Through Aetna's health plans featuring accountable care organizations (ACOs), Aetna has helped reduce costs by $29 per member, per month (PMPM) and saved $32 million compared to Aetna's standard network plans.
As Aetna continues to enhance a value-based approach to health care, the Aetna Premier Care Network Plus provides a national option that gives employers and their employees access to Aetna's most efficient network in each geography. In many parts of the country, the networks include health care providers who have established value-based relationships with Aetna.
"While most health care is delivered locally, we need to be able to support organizations that have employees located around the country," said Cain Hayes, president of Aetna National Accounts. "The Aetna Premier Care Network Plus enables employers to provide a single, simplified solution for their entire employee population."
National Network with a Local Focus
Building on arrangements with ACOs that have been in place since 2011, Aetna Premier Care Network Plus currently features ACOs in 10 locations, with plans to add more ACOs to the network in the future. These ACOs are fully integrated and offer enhanced coordination of care among doctors, hospitals, laboratories, pharmacies and other care providers. The ACOs also improve patient experience through best-in-class care management programs and the use of advanced technology that delivers actionable data and quality information to health care providers.
Since 2014, these ACOs have increased generic drug prescribing among participating health care providers and reduced inpatient hospital admissions by eight percent.
Nationally today, about 6.7 million Aetna members receive care from doctors committed to a value-based approach, with approximately 42.5 percent of Aetna medical claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 75 percent by 2020.
In more than 40 geographies covered by the Aetna Premier Care Network Plus, Aetna offers a high-performance network to members. The specialists and hospitals in these networks meet extra standards of quality and efficiency, such as shorter averages for length of hospital visits and reduced rates of hospital readmissions.
Remaining areas have access to Aetna's broad, national network of more than 1.2 million health care professionals, including more than 695,000 primary care doctors and specialists, as well as more than 5,700 hospitals.
Helping Members Find In-Network Care
Within any of these geographies and network designs, Aetna members will just need to use in-network health care providers to reduce their out-of-pocket costs. Through Aetna Navigator, their secure member website, members can find doctors, hospitals and pharmacies in their network. Members can also use Aetna Navigator to:
- Use cost-estimating tools to find out about costs before a health care service.
- Get reminders about wellness screenings and preventive exams.
- Review their plan coverage.
- Check their claims and pay their bills.
Members can also access these tools through the free Aetna Mobile app.
"We want to make it as easy as possible for our members to receive the high-quality care that they deserve through in-network health care professionals," Hayes said. "At the same time, encouraging in-network care helps reduce our members' personal out-of-pocket costs and creates savings for their employer."
Aetna is one of the nation's leading diversified health care benefits companies, serving an estimated 46.7 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 https://www.aetna.com.
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