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Aetna And Sharp HealthCare Expand Accountable Care Collaboration, Introduce Aetna Whole Health Plans To Employers In San Diego

Aetna (NYSE: AET) today announced an accountable care collaboration and the introduction of Aetna Whole Health SM, a new commercial health care product that provides members access to highly coordinated care from physicians and facilities in the Sharp HealthCare system. The new product, effective February 1, will be available to self-insured and fully insured businesses with greater than 100 employees who reside in San Diego County.

Aetna previously announced an accountable care collaboration with Sharp Community Medical Group in December 2011. The expansion of the collaboration will now include the Sharp Rees-Stealy clinics and physicians and the Sharp hospitals and ancillary facilities.

“We are excited at the opportunity to expand our collaboration with Sharp,” said Brian Ternan, Aetna’s president for Southern California. “Adding the Sharp Rees-Stealy clinics and physicians along with the Sharp hospitals and ancillary facilities will allow us to continue to improve the care for our members in San Diego County and ensure that they live healthier, more productive lives.”

The accountable care collaboration will give employers better health care options for their employees, and will feature a new model of health care delivery designed to offer:
  • A more coordinated, personalized experience for patients;
  • Cost savings to employees who use providers in the Accountable Care Network; and
  • Better health care outcomes.

Accountable care models drive focus on more coordinated care

An accountable care collaboration is a group of health care providers who assume responsibility for the quality and cost of care for a group of patients. Aetna members will receive an enhanced level of coordinated care in addition to the member benefits of their current Aetna plan.

New payment agreements reward improvements in quality and costs of care

The agreement features a new payment model to Sharp HealthCare and Sharp-affiliated physicians for meeting quality, efficiency and patient satisfaction measures, including:
  • 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.

“We are pleased to be able to serve more San Diego businesses and their employees through our expansion with Aetna,” said Mike Murphy, president and CEO of Sharp HealthCare, which was selected as a Pioneer ACO in 2011. “Our hospitals and affiliated medical groups have achieved excellent clinical quality outcomes and demonstrated their ability to control costs in a managed care environment for more than 25 years. While this approach is the foundation of new health care reform initiatives, this has been at our core for decades because it’s the right thing to do for our patients and their families.”

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