Aetna and MemorialCare Announce New Accountable Care Collaboration in Southern California

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Aetna (NYSE: AET) and MemorialCare Health System today announced an accountable care collaboration and the introduction of the Aetna Whole HealthSM  product in Orange County and select portions of Los Angeles County that will offer employers a health care model designed to improve quality, efficiency and the patient experience. The health care savings will be specific to each employer, with the potential to save up to 15 percent over comparable broad network Aetna products.

The new commercial health care product, Aetna Whole HealthSM – MemorialCare, will provide Aetna members with highly coordinated care from approximately 2,000 doctors, which includes more than 500 primary care providers, along with seven award-winning hospitals and over 40 urgent care centers.

The plans will be available to self-insured businesses in Orange County and portions of Los Angeles County, which includes Long Beach and the South Bay, beginning Sept. 1 for an effective date of Nov.1. The plans are anticipated to be available for fully insured customers in early 2016.

Aetna members already enrolled in a fully insured plan and who have seen a MemorialCare physician in the last 12 months automatically will become part of the collaboration on Oct. 1. Those members will receive the additional benefit of an integrated care delivery model, which includes the tracking of metrics to achieve higher quality care and lower costs. 

“Aetna is excited to introduce our Aetna Whole HealthSM  product to Orange County, Long Beach and the South Bay areas,” said Rich Lee, Aetna’s president for Southern California. “By working with MemorialCare, we will be able to provide a total health solution that will ensure Aetna members receive high-quality, convenient care that will help them live healthier and more productive lives.”

The accountable care collaboration gives employers innovative health care options for their employees, and will feature a new model of health care delivery designed to offer:

  • Cost savings to employees who use providers in the Aetna Whole HealthSM – MemorialCare network;
  • A more coordinated, personalized experience for patients; and
  • Better health care results.

“We are proud to team with Aetna to unveil a new health plan option for businesses and their employees that offers easy access to a large comprehensive network,” added Barry Arbuckle, Ph.D., MemorialCare Health System president and CEO. “This advances our commitment to highly personalized health care that focuses on achieving exceptional outcomes, improving the health of our communities, helping patients achieve healthier lives and partnering with patients, physicians, employers, health plans and communities to further these goals.”

New payment agreements reward improvements in quality and costs of care

The agreement features a new payment model to reward providers for meeting 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 avoidable hospital readmission rates; and
  • Reductions in emergency room visits.

Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. Nationally today, about 3.2 million Aetna members receive care from doctors committed to the value-based approach, with 30 percent of Aetna claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 50 percent by 2018 and 75 percent by 2020.