How Aetna's health system partnership reduced waste, cut costs

Since partnering with Virginia's Inova Health System in 2012, Aetna has been able to reduce waste and lower costs by as much as 15 percent, reported the Sun Gazette.

The partnership created Innovation Health, a jointly owned health plan that encourages doctors to provide high-quality, low-cost healthcare through financial incentives, FierceHealthPayer previously reported.

Innovation Health now has 172,000 members and has cornered an 11 percent share of the region's market. More than 1,400 small businesses offer Innovation Health plans to their employees, and 38,000 people have bought its services on the federal health insurance exchange.

"This was the first of its kind," Innovation Health CEO David Notari told the Gazette. "In the past, hospitals and insurance companies were adversaries. It put the consumer in the middle of the mess. Here, the incentives are aligned and the consumer benefits at the end of the day."

Much of its success has come from Innovation Health's ability to leverage Aetna's pharmacy benefit plan and price structure, which has let it increase the number of lower-cost generic prescriptions by 21 percent.

Innovation Health also has established a clear communication channel so that doctors are kept informed about their patients' status. For example, the Aetna-Inova partnership has created a daily "census feed" that describes the whereabouts of all patients and pairs that information with clinical data to identify gaps in medical care. "Usually, in the past, the insurance company didn't know a patient was in the hospital until the claim arrived," Notari said.

Beginning next year, Innovation Health is planning to launch technology that will eliminate paperwork in small markets by allowing members to register online. "We'll be the first in the area to offer a paperless system," Notari said. "Healthcare is an old, stodgy business that hasn't adapted well to technology. We need to hold ourselves accountable for that."

To learn more:
- read the Sun Gazette article