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Aetna and the Value Care Alliance Reach New Accountable Care Agreement

Aetna (NYSE: AET) and the Value Care Alliance (VCA), the state’s largest collaboration of independent health care providers, today announced a new accountable care agreement that is designed to improve the coordination and delivery of patient care to Aetna members in Connecticut.

The VCA comprises seven member hospitals and their affiliated physicians in Fairfield, Litchfield, Middlesex, New Haven and New London counties. The hospitals are: Griffin Hospital in Derby; Lawrence + Memorial Hospital in New London; Middlesex Hospital in Middletown; St. Vincent’s Medical Center in Bridgeport; and the Western Connecticut Health Network which comprises Danbury Hospital, New Milford Hospital and Norwalk Hospital.

Aetna members who receive care from VCA providers will experience more coordinated care, and will benefit from the improved flow of information to treating physicians in the ACO, particularly those patients with chronic or complex conditions. Aetna nurse case managers will work with the ACO to assist in care coordination, outreach and follow-up services.

“This agreement builds upon a strong foundation of collaboration already at work within the VCA and will enable Aetna to add support for the care delivered by the VCA to our members,” said Mark Santos, president, Aetna – New England. “Aetna will work closely with VCA physicians and member hospitals to find opportunities to share health information to improve care for Aetna members, close gaps in care and reduce waste. We are creating a loop of improved information to drive better care.”

Covered under the new agreement are more than 40,000 Aetna commercial health plan members who primarily received care from participating VCA providers over the last 24 months, as well as those who seek care from VCA providers following the start of the agreement. While health plan benefits will not change, members can expect a more highly coordinated, personalized level of care. To support these members, care coordinators at VCA member hospitals will complement Aetna’s care management programs in an effort to lower the number of days patients spend hospitalized and improve member health outcomes.

“This innovative approach to the delivery of health care strengthens our community’s access to affordable, high-quality care,” said John M. Murphy, MD, president and CEO of the three-hospital Western Connecticut Health Network. “The real beneficiaries of this agreement are the people we serve every day in our communities. This partnership will produce tangible and meaningful improvements in our ability to coordinate care, which is why we are so pleased to be a part of this progressive collaboration.”

This agreement includes a shared savings model that rewards VCA providers for meeting certain quality and efficiency benchmarks that have been proven to improve the health of members and reduce healthcare costs, 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.

“The focus of the VCA is to provide high-quality and low-cost health care including effective prevention and wellness services that benefit Connecticut consumers, employers and health plans,” said Vincent Capece, CEO of Middlesex Hospital. “Our accountable care partnership with Aetna will enhance our ability to provide care that is patient-centered, high-quality and efficient in a more coordinated manner.”

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 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. This accountable care agreement with the VCA is in keeping with the transition to more value-based care arrangements.

“The VCA has evolved quickly since its founding in 2014, with its members working collaboratively to enhance quality and reduce cost by identifying and sharing best practices and to develop the capabilities necessary to effectively manage the health of populations,” said Patrick Charmel, chairman of the VCA and president and CEO of Griffin Hospital. “We welcome Aetna’s industry-leading effort to motivate, facilitate and reward the delivery of high-value, patient-centered health care. We also appreciate Aetna’s accountable care partnership and the confidence in, and support of, the Value Care Alliance that it demonstrates.

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