Aetna, WellSpan Health Create Accountable Care Organization in Central Pennsylvania

Wednesday, October 9, 2013

HARRISBURG, Pa. – Aetna (NYSE: AET) and WellSpan Health (WellSpan) today announced a new accountable care organization (ACO) agreement that is designed to improve the quality of care and lower overall health care costs for Aetna commercial plan members and for communities WellSpan serves. The contract is Aetna’s first ACO agreement in Pennsylvania.

Using WellSpan’s comprehensive, integrated system of physicians, hospitals and ambulatory services, the collaboration will give area employers better health care options for their employees by:

  • creating a more coordinated patient experience;
  • saving employees money when they use providers aligned with WellSpan; and
  • improving health care outcomes.

Aetna will introduce both fully insured and self-insured health plans in Central Pennsylvania that will use WellSpan’s community-based systems of care and its network of highly respected physicians. A fully insured product will be available on April 1, 2014.

“We are very excited to announce this innovative new agreement with WellSpan,” said Patrick Young, president of Aetna’s Pennsylvania and Delaware operations. “We’re changing the relationship between health systems and insurers, and creating a model that will improve health care quality, efficiency and affordability.”

“At WellSpan, we have always believed that collaborations are among the most effective means to serve the needs of our communities,” said Kevin Mosser, M.D., president and CEO of WellSpan Health. “We are also committed to developing new ways to help our neighbors reach their health goals in life. Innovative relationships such as this hold much potential to improve the quality and efficiency of health care in our region.”

Under the agreement, WellSpan bears risk for the quality and cost outcomes for Aetna members who see WellSpan physicians. Aetna and WellSpan jointly agreed upon a set of metrics surrounding 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 hospital readmission rates; and
  • reductions in avoidable emergency room visits by improving primary care access hours.

Accountable care models drive focus on more coordinated care

ACOs 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. Its solutions help all types of patients, regardless of payer. Information about Accountable Care Solutions from Aetna is available at www.aetnaacs.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 44 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.

About WellSpan Health

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 600 providers, four respected hospitals, more than 11,000 employees, 45 outpatient locations, home health services and two outpatient surgery centers. WellSpan is consistently recognized by SDI as one of the Top 100 Integrated Health Networks in the United States and has been recognized by Health Imaging and IT as one of the nation’s “Top 25 Connected Healthcare Facilities.” For more information, visit www.wellspan.org.

Aetna Contact:

Walt Cherniak
410-401-9490
cherniakjrw@aetna.com

WellSpan Health:

Barry Sparks
717-851-3151
bsparks@wellspan.org

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