--Serving more than 16,000 members in
Camden, Burlington and Gloucester counties--
Aetna (NYSE: AET) and the Virtua Medical Group (VMG) today
announced a new accountable care agreement that will expand on an
existing Medicare Collaboration already serving an estimated 2,000
Aetna Medicare Advantage Members since July 2012. The new
accountable care agreement is designed to improve the coordination
and delivery of patient care and provide a better patient
experience for more than 16,000 Aetna commercial members in Camden,
Burlington and Gloucester counties.
The VMG primary care practices include more than 95 physicians
and other care providers. The practices are recognized as
Patient-Centered Medical Homes by the National Committee for
Quality Assurance. The VMG primary care practitioners are supported
by Virtua Medical Group and Virtua Surgical Group specialty
physicians as well as by a large hospital network including Virtua
Memorial Hospital, Virtua Marlton Hospital and Virtua Voorhees
Hospital.
Aetna members who receive care from VMG primary care physicians
will be served under this new agreement. VMG will be accountable
for cost, quality and patient satisfaction for the health care they
provide. Aetna nurse case managers will work with physicians and
the hospitals to assist in care coordination, outreach and
follow-up services for Aetna members.
Aetna members served under this agreement will experience more
highly coordinated care, particularly for those patients with
chronic or complex conditions. They also will have enhanced access
to appropriate care and will benefit from the improved flow of
information to VMG physicians who provide treatment.
“We are delighted to expand our existing Medicare Collaboration
with Virtua under this new agreement, and to bring the benefits of
this value-based model of care to our members in southern New
Jersey and southeastern Pennsylvania. We look forward to expanding
our agreement even further over the coming months,” said John
Lawrence, president, Aetna – New Jersey. “This agreement aligns
with the federal government’s recently announced goal of expanding
value-based agreements to more people over the next several
years.
“Aetna will work closely with the VMG physicians to identify
specific areas where we can either develop or improve on the
sharing of specific, useful health information. In turn, the
physicians will use this information to improve care for patients,
close gaps in care and reduce waste. We are creating a continuous
loop of improved information to drive better care. Working
together, we aim to bring better health, better care and lower
costs to thousands of Aetna members.”
“Virtua and Aetna share a common vision for providing a
continuum of care for our patients in a value-based delivery model
that emphasizes clinical excellence and effectiveness, coordinated
access, and excellent customer service,” said Richard P. Miller,
Virtua President and CEO. “Our expanded relationship with Aetna is
a demonstration of our overall mission to help patients be well,
get well and stay well.”
Aetna members who have been treated by VMG affiliated physicians
over the last 24 months will be covered by this agreement. Their
benefits will not change, but those members will be part of a
select group that will receive highly coordinated, personalized
care. The agreement went into effect on January 1, 2015 for
fully-insured customers and will be effective May 1, 2015, for
self-insured customers.
The careful tracking of quality metrics is a critical part of
why accountable care organizations are successful at improving
patient care and are fundamental to the incentive structure. This
agreement includes a shared savings model that rewards Virtua
physicians for meeting certain quality and efficiency measures such
as:
- The percentage of Aetna members who
receive 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 unnecessary emergency
room visits.
Aetna is working with health care organizations nationwide to
develop products and services that support value-driven,
patient-centered care for all health care consumers. Nationally
today, about 3.2 million Aetna members receive care from doctors
committed to the value-based approach, with 28 percent of Aetna
claims payments go 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. In New Jersey, Aetna has
nearly 230,000 members or 21 percent of its members served through
value-based collaborative arrangements, including ACOs, with the
intent to reach over 400,000 or 35% of its members during 2015.
About Aetna
Aetna is one of the nation's leading diversified health care
benefits companies, serving an estimated 46 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 www.aetna.com and learn
about how Aetna is helping to build a healthier world. @aetna
About Virtua
As one of New Jersey’s largest health systems, Virtua helps
people be well, get well and stay well through a comprehensive
range of health care services. Services are delivered through three
health and wellness centers, three fitness centers, three acute
care hospitals, primary and specialty physician practices with more
than 240 physicians, urgent care centers, nine ambulatory surgery
centers, home health services, two long-term care and
rehabilitation centers, 12 paramedic units and a wide range of
outpatient services. A leader in maternal and child health
services, Virtua delivers more than 8,000 babies a year.
Virtua also provides employment and wellness services to 1,700
businesses and corporations. An innovator in clinical and
information technology such as electronic medical records, Virtua
is recognized for its ground-breaking partnerships with GE
Healthcare, Children's Hospital of Philadelphia (CHOP) and
the Fox Chase Cancer Center.
Virtua employs more than 8,700 people and has been honored as the
#1 Best Place to Work in the Delaware Valley every year since 2007.
It is the recipient of the Consumer Choice Award from the National
Research Corporation. For more information, visit www.virtua.org or
www.virtuabroadcastnetwork.org.
AetnaMedia Contact:Susan Millerick,
860-273-0536MillerickS@aetna.comorVirtuaMedia Contact:Peggy
Leone, APR, MA, 856-355-0821pleone@virtua.org
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