Collaboration will give area employers better health care options for their employees
WellSpan and Aetna have announced a new accountable care organization (ACO) agreement that is designed to improve the quality of care and lower overall health costs for Aetna commercial plan members and for communities WellSpan serves.
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 who are closely aligned with WellSpan
- Improving health care outcomes
ACOs are alliances of physicians, hospitals and other providers who 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, one of the nation’s leading diversified health care benefits companies, will introduce both fully insured and self-insured health plans in Central Pennsylvania that will utilize WellSpan’s community-based systems of care and its network of highly respected physicians. A fully insured product will be available April 1, 2014.
“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.
“We are 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.”
Mosser said the American health system has begun to transform from one that primarily treats individuals when they are sick or injured to one that also manages the health of populations.
Patrick Young, president of Aetna’s Pennsylvania and Delaware operations, said, “We are very excited to announce this innovative new agreement with WellSpan. We’re changing the relationship between health systems and insurers, and creating a model that will improve health care quality, efficiency and affordability.”
The ACO is Aetna’s first Accountable Care Solutions contract in Pennsylvania, and the company’s
first full-risk arrangement.
The agreement features a new payment model that emphasizes 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
- Reductions in avoidable emergency room visits by improving primary care access hours
- An enhanced level of coordinated care.