Aetna (NYSE: AET) and Optimus HealthCare Partners today announced a new accountable care agreement in New Jersey. The agreement is the only one between Optimus and a health plan to include Optimus primary care, pediatric and specialist physicians. The agreement is designed to improve the quality of care for Aetna members and lower overall health care costs. Aetna members covered under fully insured plans as well as Aetna Medicare Advantage members in Union, Somerset, Essex, Middlesex, Monmouth, Ocean, Warren, Morris and Hunterdon counties are included. “We are pleased to be working with Aetna through an accountable care arrangement that focuses on the triple aims of improving patient satisfaction, improving patient outcomes, and doing this in a cost-efficient manner,” stated Dr. Thomas Kloos, president and CEO of Optimus. “Our physicians have had a long-standing, collaborative relationship with Aetna. This is the next evolution. We look forward to working closely together.” John Lawrence, president of Aetna’s New Jersey operations, said, “We are excited about this unique agreement with Optimus. We know it will make the health experience better for our New Jersey members. Optimus physicians will ensure that no matter what their health care needs may be, our members will receive more outreach and coordination to make the entire experience simpler and more effective.” The Optimus accountable care model is available now to the approximately 11,900 fully insured Aetna members who received care from Optimus physicians in the last 24 months. In addition, Aetna is implementing a Medicare Provider Collaboration model with Optimus to support Medicare Advantage members. Aetna already covers 1,800 members in this type of agreement with Vista IPA, one of the founding organizations of Optimus Healthcare Partners. Many Medicare members have complex health care needs. Aetna nurse case managers work closely with physicians to coordinate and improve the care for these members and ensure adherence to best practices and treatment plans.
In a study published in Health Affairs , Aetna’s Medicare Provider Collaboration program was shown to:
- Significantly reduce hospital admissions and readmissions;
- Increase preventive care; and
- Reduce health care costs for the study population compared to unmanaged Medicare.
- The percentage of Aetna members who receive recommended preventive care and screenings;
- Better management of patients with chronic conditions such as diabetes and heart failure;
- Reductions in avoidable hospital readmissions; and
- Reductions in Emergency Room visits by improving primary care access hours and care coordination.
About AetnaAetna is one of the nation's leading diversified health care benefits companies, serving approximately 37.3 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 and health information technology services. Our 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.