Aetna Premier Care Network Plus Helps Reduce Costs for National Employers and Members Through Simple Access to Value-Based Care
November 30 2016 - 9:00AM
Business Wire
Aetna (NYSE: AET) has worked with health care organizations
nationwide since 2011 to develop products and services that support
value-driven, patient-centered care for consumers and also help
reduce health care costs. Through Aetna’s health plans featuring
accountable care organizations (ACOs), Aetna has helped reduce
costs by $29 per member, per month (PMPM) and saved $32 million
compared to Aetna’s standard network plans.
As Aetna continues to enhance a value-based approach to health
care, the Aetna Premier Care Network Plus provides a national
option that gives employers and their employees access to Aetna’s
most efficient network in each geography. In many parts of the
country, the networks include health care providers who have
established value-based relationships with Aetna.
“While most health care is delivered locally, we need to be able
to support organizations that have employees located around the
country,” said Cain Hayes, president of Aetna National Accounts.
“The Aetna Premier Care Network Plus enables employers to provide a
single, simplified solution for their entire employee
population.”
National Network with a Local FocusBuilding on
arrangements with ACOs that have been in place since 2011, Aetna
Premier Care Network Plus currently features ACOs in 10 locations,
with plans to add more ACOs to the network in the future. These
ACOs are fully integrated and offer enhanced coordination of care
among doctors, hospitals, laboratories, pharmacies and other care
providers. The ACOs also improve patient experience through
best-in-class care management programs and the use of advanced
technology that delivers actionable data and quality information to
health care providers.
Since 2014, these ACOs have increased generic drug prescribing
among participating health care providers and reduced inpatient
hospital admissions by eight percent.
Nationally today, about 6.7 million Aetna members receive care
from doctors committed to a value-based approach, with
approximately 42.5 percent of Aetna medical claims payments going
to doctors and providers who practice value-based care. Aetna has
committed to increasing that number to 75 percent by 2020.
In more than 40 geographies covered by the Aetna Premier Care
Network Plus, Aetna offers a high-performance network to members.
The specialists and hospitals in these networks meet extra
standards of quality and efficiency, such as shorter averages for
length of hospital visits and reduced rates of hospital
readmissions.
Remaining areas have access to Aetna’s broad, national network
of more than 1.2 million health care professionals, including more
than 695,000 primary care doctors and specialists, as well as more
than 5,700 hospitals.
Helping Members Find In-Network CareWithin any of these
geographies and network designs, Aetna members will just need to
use in-network health care providers to reduce their out-of-pocket
costs. Through Aetna Navigator, their secure member website,
members can find doctors, hospitals and pharmacies in their
network. Members can also use Aetna Navigator to:
- Use cost-estimating tools to find out
about costs before a health care service.
- Get reminders about wellness screenings
and preventive exams.
- Review their plan coverage.
- Check their claims and pay their
bills.
Members can also access these tools through the free Aetna
Mobile app.
“We want to make it as easy as possible for our members to
receive the high-quality care that they deserve through in-network
health care professionals,” Hayes said. “At the same time,
encouraging in-network care helps reduce our members’ personal
out-of-pocket costs and creates savings for their employer.”
About AetnaAetna is one of the nation’s leading
diversified health care benefits companies, serving an estimated
46.7 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 https://www.aetna.com/ and learn about how Aetna
is helping to build a healthier world. @AetnaNews
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version on businesswire.com: http://www.businesswire.com/news/home/20161130005760/en/
Media Contact:AetnaEthan Slavin,
860-273-6095SlavinE@aetna.com
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