Aetna and Carilion Clinic Announce Plans to Collaborate on Accountable Care Organization
March 10 2011 - 2:34PM
Business Wire
Aetna (NYSE:AET) and Carilion Clinic, the largest health care
provider in southwest Virginia, today announced their intention to
collaborate in an accountable care organization (ACO) initiative.
The new model of health care delivery will help lower costs through
more effective patient outreach and engagement and a new payment
model that rewards providers for the collective outcomes of
patients.
“Working together with a shared vision, we believe we can
develop a continuum of care that will be a game-changer in the
industry and a great benefit to our patients,” said R. Wayne
Gandee, M.D., Carilion Clinic’s chief medical officer. “We are
already on similar paths. Carilion is working to coordinate and
improve care on the provider side, and Aetna is doing the same from
the health plan perspective.”
The Aetna-Carilion relationship is ultimately expected to
encompass the following key areas:
- co-branded commercial health care plans
for businesses and individuals available later this year;
- joint opportunities to better meet the
personalized care needs of patients, including Medicaid
beneficiaries in Virginia; and
- new payment models that encourage
providers to share accountability to improve patients’ health,
including rewards for meeting quality targets and shared costs
savings.
Carilion Clinic plans to continue to offer Medicare Advantage
products and intends to purchase administrative services through
Aetna to lower administrative costs of the products. Aetna also
would become the administrator of Carilion’s health benefits plan
for its employees.
“Carilion and Aetna's mutual customers and patients are asking
to receive more value for their health care dollars,” said Charles
Saunders, M.D., president of Strategic Diversification at Aetna.
“Our collaboration is designed to bring new models of health care
delivery, advanced technology and payment reform to the market that
creates improvements in both quality and affordability of care. By
bringing the best capabilities of each organization and aligning
incentives across all stakeholders, we can create real value.”
Connecting doctors with information and empowering
patients
Members and doctors will benefit from more effective and
coordinated treatments. Carilion’s accountable medical group
features a fully integrated electronic medical record to support
information sharing and a comprehensive network of primary care
physicians, specialists, hospitals and outpatient facilities. Aetna
members using Carilion will have more information and control over
their health decisions and dollars through Aetna’s online resources
including pricing and quality, and wellness tools.
A foundation for the future
“Aetna is exploring new ways to work with health care providers,
and we’ve found that these discussions are positively received as
we collectively seek to improve the health care system,” said
Thomas Grote, president of Aetna’s Maryland, Virginia and
Washington, D.C., markets. “Our arrangement with Carilion will
provide a foundation to grow these new models of care.”
“We have a lot of exciting work to do; some will take time to
develop,” Gandee says. “We view the ACO initiative as the beginning
of a long-term relationship with Aetna.”
Carilion Clinic physicians and facilities will continue to
participate in existing health plan provider networks and will
continue to accept members of Aetna plans as well as other private
insurance plans.
About Aetna
Aetna is one of the nation’s leading diversified health care
benefits companies, serving approximately 35.3 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 and health care management services for
Medicaid plans. Our customers include employer groups, individuals,
college students, part-time and hourly workers, health plans,
governmental units, government-sponsored plans, labor groups and
expatriates. For more information, see www.aetna.com. To learn more
about Aetna's innovative online tools, visit
www.aetnatools.com.
About Carilion Clinic
Carilion Clinic is a not-for-profit health care organization
serving nearly one million people in Virginia through hospitals,
outpatient specialty centers and advance primary care practices.
Led by multi-specialty physician teams with a shared philosophy
that puts the patient first, Carilion is committed to improving
outcomes for every patient while advancing the quality of care
through medical education and research. For more information visit
www.carilionclinic.org/about.
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