Aetna drives value-based reform by collaborating with one provider in market


Aetna has experienced a lot of success with its accountable care organizations, in which it establishes a trusting relationship with its provider partners to steer value-based reform throughout the country. One of the keys to that success has been choosing one major integrated health system in each market to partner with--and then excluding all the other providers in the area.

"When we've worked with an ACO and helped a delivery system launch an ACO, it's been very successful. We've been able to drive large amounts of patient volume to our partner," Charles Kennedy, CEO of Aetna's Accountable Care Solutions, said at the Health IT Summit in the District of Columbia, reported Healthcare Informatics.

In partnering with a dominant health system, Aetna helps the provider deploy data analytics and population health strategies to increase efficient care. Aetna also works with the provider's leaders to merge clinical and claims data to improve outcomes. In fact, Aetna shares all of its claims data with its provider partners, believing that information empowers providers to deliver a higher quality of care at a lower cost, FierceHealthPayer previously reported.

For example, Aetna partnered with Inova Health System, a five-hospital system based in Falls Church, Virginia, that dominates the District of Columbia-area with more than a 60 percent market share. Kennedy said the shared savings program that Aetna created with Inova, which was profitable in its first year of operations, is a perfect example of how the insurer works with integrated healthcare systems all over the nation, noted Healthcare Informatics .

That success was a direct result of the "commitment from both organizations to collaboration and to data-sharing; but also, we created shared financial incentives," Kennedy said.

To learn more:
- read the Healthcare Informatics article

Related Articles:
ACOs leverage data analytics for quality care
Aetna: ACOs need data sharing, mobile health
Aetna: Empower providers with data for ACO success
ACOs require payer-provider trust