ACOs require payer-provider trust


Having already launched 40 accountable care organizations, Aetna views a trusting relationship between the participating payer and provider as a key component to these arrangements.

"It's an over-used phrase, but we really do make it a win-win strategy," Gary Anthony, head of enablement services at Aetna, told Healthcare Informatics. "We make sure we get their trust and work collaboratively together," he said.

With that in mind, Aetna has created joint operating committees with physicians and a good governance structure for each of its ACOs.

Developing trust among providers also involves considering the specific culture of each provider organization. Because providers transition from fee-for-service to value-based care differently, Aetna engages with provider groups in a unique manner. The insurer offers a robust advisory service to help providers determine where they are along that value-based shift, according to Healthcare Informatics. That service addresses several nuances, such as specific culture, alignment and technologies for each provider group.

"There's certainly a level of consistency and similarity in how we go to the market, but certainly there are uniquenesses around how you'll work with a provider to drive market growth or engage major employers in an area or work on health information exchange," Anthony said.

Because of this emphasis on trust and collaboration, Aetna's ACO provider partners speak very highly of the insurer. Providers consider Aetna to be more forward thinking in regards to sharing and partnering in its ACO strategy.

Aetna's ACO strategy empowers providers with unprecedented access to claims data. "Our goal is to make the delivery system mission and vision a reality and we think we can support them in servicing their mission and achieving their vision," Charles Kennedy, CEO of Aetna's accountable care solutions, previously told FierceHealthPayer in an exclusive interview. "We have to be able to accommodate the unique needs of each partner we do business with," he explained.

To learn more:
- read the Healthcare Informatics article

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