Fierce Q&A: New Aetna ACO leverages health IT


Aetna last week announced it's launching a new accountable care organization (ACO) with New Jersey's Hunterdon Medical Center and its 225 affiliated doctors to enhance care coordination and to revamp payment models. To find out what pushed the insurer to establish its newest ACO and how it intends to leverage its health IT capabilities, FierceHealthPayer spoke with Aetna's CEO of Accountable Care Solutions Charles Kennedy.

FierceHealthPayer: What are the key goals of Aetna's new ACO?

Charles Kennedy:
Hunterdon Healthcare is establishing an ACO to deliver a better patient experience and aims to improve the quality of patient care while reducing the overall cost of care. Patients will receive an enhanced level of coordinated care, in addition to the benefits of their current Aetna plan.

FHP: How is Aetna leveraging technology within the ACO?

Kennedy:
Aetna will implement integrated technologies to support clinical integration, population health and patient services for Hunterdon Healthcare: 

  • health information exchange technology from Medicity, a wholly-owned subsidiary of Aetna, to enable the secure, two-way exchange of health information across a patient's entire care team, including hospitals, physicians, labs, pharmacies and other ambulatory services;
  • point-of-care clinical decision support services and the Active CareTeam desktop-based workflow tool to track, monitor, coordinate and report on patient health outcomes from ActiveHealth Management, a wholly-owned subsidiary of Aetna; and
  • reporting tools that will help Hunterdon Healthcare providers evaluate how they are performing against their targeted clinical and financial outcomes.

FHP: How will Aetna coordinate patient care?

Kennedy:
Working together, and supported by a full suite of Aetna health information technology and care management capabilities, the Hunterdon providers will become part of a coordinated healthcare network and receive notices of any treatments and medications the patient may be receiving. 

As a result, the patients will receive an enhanced level of coordinated care, in addition to the member benefits of their current Aetna plan. Hunterdon will manage Aetna patients with chronic conditions proactively to prevent unnecessary emergency room visits and hospital admissions.

FHP: What payment model will Aetna use for doctors participating within the ACO? And what type of measures will Aetna use to evaluate those doctors?

Kennedy:
The payment model is one in which members are attributed to the Hunterdon ACO based on receiving care from Hunterdon Healthcare primary care physicians and associated specialists in the last 24 months. Hunterdon will be paid based on achieving certain mutually agreed upon quality, efficiency and patient satisfaction measures. Initially, the agreement is a gain-share model but is expected to move to a risk-based payment model over time.

FHP: Does Aetna believe that technology is the lynchpin to create successful ACOs? And, if so, does it plan to use similar technology for future ACO relationships?

Kennedy:
Yes, Aetna believes technology is a foundational requirement for ACOs. Providers need to be able to exchange, analyze and act on patients' clinical and claim information at the population and individual levels. Since 2005, we have invested more than $2 billion to acquire or build a variety of capabilities to support and enable accountable care models.

Our technologies include, but are not limited to, clinical analytics, quality measurement, risk stratification; care management programs and clinical decision support from ActiveHealth Management; health information exchange from Medicity; and mobile and social consumer health engagement tools, including iTriage.

We are deploying a wide range of technology capabilities in our ACO agreements. Our technology capabilities are able to support providers with any payer and any patient population.

This interview has been edited and condensed for clarity.

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