As groups throughout the health care system begin to create Accountable Care Organizations (ACOs), Aetna (NYSE: AET) today announced results of a collaborative relationship with NovaHealth, the independent physician association founded by InterMed, based in Portland, Maine. The September edition of Health Affairs, which focuses on payment reform in the health care system, features the results.
Since 2008, NovaHealth doctors participating in Aetna’s Medicare Provider Collaboration program have provided care to approximately 750 Aetna Medicare Advantage members. Through the program, Aetna and NovaHealth have achieved two main goals of ACOs: improving quality of care and lowering health care costs. The most recent results from 2011 show that:
- Patients in the program had 50 percent fewer inpatient hospital days, 45 percent fewer hospital admissions, and 56 percent fewer readmissions than unmanaged Medicare populations statewide.
- More than 99 percent of these Aetna Medicare Advantage members visited their doctors in 2011 to receive preventive and follow-up care.
- NovaHealth’s total per member, per month costs for its Aetna Medicare Advantage members were 16.5 to 33 percent lower cost across all medical cost categories than for other Aetna Medicare Advantage members not cared for by NovaHealth.
“We are working more effectively and efficiently with outstanding health care providers like NovaHealth. Now, we have demonstrated that we can help improve the coordination and quality of care and reduce health care costs,” said Randall Krakauer, MD, FACP, FACR, Aetna’s national Medicare medical director. “Aetna believes patient-centered collaboratives are a stepping stone to Accountable Care Organizations, which further align financial incentives with high quality, more efficient care.”
Coordinated Care Helps Improve Health OutcomesAetna’s Provider Collaboration program has also demonstrated positive results with population health management. Through the Provider Collaboration program, NovaHealth has met a number of clinical quality metrics agreed upon by both sides, including:
- Increasing the percentage of Aetna Medicare Advantage members who have an office visit each calendar year;
- Encouraging office visits every six months for members with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) or diabetes;
- Encouraging HbA1C (blood glucose) tests each calendar year for members with diabetes; and
- Confirming that members schedule follow-up visits within 30 days of being discharged from an inpatient stay.
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