-- Rewards Primary Care Physicians for Improved Patient Care Coordination --
HARTFORD, Conn.--(BUSINESS WIRE)-- Aetna (NYSE: AET) announced today a national Patient-Centered Medical Home (PCMH) program that will begin in Connecticut and New Jersey. The program recognizes primary care physicians (PCPs) who more actively coordinate and manage their patients’ care across the health care system. By strengthening the role of PCPs, the PCMH program aims to improve patient health outcomes.
“Patient-centered care is something Aetna has always advocated. Our PCMH program rewards PCPs who focus on the patient’s entire health needs, not just a single condition,” said Elizabeth Curran, head of National Network Strategy and Program Development for Aetna. “As a result, members may experience better health, fewer hospitalizations, improvements in transitions of care, and greater engagement. The PCMH program is one more way we are moving from a system that rewards the quantity of procedures to a system that rewards quality outcomes.”
Primary care providers who participate in Aetna’s networks, who have been recognized by the National Committee for Quality Assurance (NCQA)* as a PCMH, and who are not participating in other quality incentive programs with Aetna will receive a quarterly Coordination of Care payment for each commercial (non-Medicare) Aetna member in their care. The NCQA-recognized PCMH practices are recognized for providing a number of services, including:
- Improved access to care, such as the ability to reach health professionals outside normal business hours
- Proactive and planned preventive care (screenings, physicals, labs)
- Improved access through non-face-to-face visits (e-mail, web, phone)
- Access to nurses and other health care professionals, allowing more focused physician visits
Aetna serves 460,000 commercial members in Connecticut, and 1.2 million commercial members in New Jersey. More than 400 physicians are currently part of the growing program. The company expects to expand the PCMH program nationally during 2012.
* For multi-site physician groups, at least half of the locations must receive NCQA recognition for the groups’ physicians to qualify for the PCHM payment.
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 36.3 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 and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com.
KEYWORDS: United States North America Connecticut New Jersey
INDUSTRY KEYWORDS: Practice Management Health Professional Services Insurance General Health