Aetna, NAMM Form Accountable Care Collaboration and Introduce New Health Plans in San Bernardino and Riverside Counties

Aetna, NAMM Form Accountable Care Collaboration and Introduce New Health Plans in San Bernardino and Riverside Counties

<0> AetnaAnjie Coplin, 214-200-8056 </0>

Aetna (NYSE: ) and North American Medical Management, California, Inc. (NAMM), a member of the Aveta Inc. family of companies, today announced an accountable care collaboration and the introduction of PrimeCare Physicians Plans, an Aetna Whole Healthproduct. The health plans are designed for small and mid-sized businesses with employees who reside in Riverside and San Bernardino counties, and will be offered through NAMM’s affiliate, PrimeCare Medical Network, Inc. (PrimeCare), an organization comprised of independent practice associations. The PrimeCare Physicians Plans will be effective beginning December 1, 2012.

The plans feature a new model of health care delivery designed to offer:

“Companies are struggling to provide affordable, comprehensive health benefits to their employees in this current economic environment,” said Brian Ternan, Aetna’s president for Southern California. “This collaboration with PrimeCare enables us to offer improved quality and more cost-effective products to our plan sponsors in the Inland Empire.”

The hospitals and providers in the PrimeCare Physicians Plans Network will use information technology to assist in coordinating care, delivering NAMM clinical decision support and actively engaging people in their overall health. Members will receive:

“Working with Aetna to develop PrimeCare Physicians Plans will enable us to extend our care model to employer groups seeking affordable, quality coverage for their employees,” stated Leigh Hutchins, president and COO of NAMM and PrimeCare. “Our physician network has provided a high level of care coordination to the communities of the Inland Empire for over 17 years to support patient satisfaction and health, and lower cost. We expect that our close working relationship with Aetna will continue to result in joint development of new programs and products for the benefit of patients.”

Aetna and PrimeCare implemented a risk-sharing agreement designed to compensate and reward PrimeCare physicians based on achieving certain quality, efficiency and patient satisfaction measures, with the triple aims of:

1. Improving the patient’s health care experience through greater care coordination and patient engagement;

2. Improving quality of care of the health of populations; and

3. Reducing the per capita costs of health care by aligning payment with quality, patient outcomes and value.

“Aetna is excited to be working with PrimeCare and the physicians and hospital in the PrimeCare Network to transform patient care and build a more effective, sustainable health care delivery model for Riverside and San Bernardino counties,” said Charles D. Kennedy, M.D., Aetna chief executive of Accountable Care Solutions. “Aetna’s agreement with PrimeCare is another example of how we are working with physician groups to give our members access to a better quality health care experience for their money.

PrimeCare Physicians Plans offers a variety of Aetna Whole Health plans to give businesses the flexibility and choice to best meet their needs—health maintenance organization (HMO), Open Access Managed Choice (MC) and PPO plans.

NAMM develops and manages provider networks, offering a full range of services in Southern California to assist physicians and other provider organizations in patient care coordination and business operations. NAMM brings together 16 physician organizations including the independent practice associations under PrimeCare, Mercy Physicians Medical Group, Coachella Valley Physicians, and Primary Care Associates – a network that includes over 575 primary care physicians and 9,000 specialists serving more than 49,000 senior members and 183,000 commercial members. Additionally, PrimeCare is one of 32 organizations selected by the Centers for Medicare and Medicaid Services to participate in the Pioneer ACO model. For more information, visit .

NAMM is part of the Aveta Inc. family of companies – one of the largest providers of managed healthcare services in the United States. Redefining healthcare management to meet the challenges of today’s complex healthcare environment, Aveta develops innovative models that coordinate care for more than 280,000 Medicare beneficiaries and more than 275,000 commercial members, Aveta builds provider networks and Medicare Advantage programs that are sustainable, cost-effective and utilize advanced technologies. The company is headquartered in Fort Lee, New Jersey, and currently has operating subsidiaries in California, Illinois, Arizona, Kansas City, East Tennessee and Puerto Rico. For more information, visit .

Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 36.7 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 and health information technology services. Our 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 .