Aetna Building National ACO Network

Margaret Dick Tocknell, for HealthLeaders Media , May 16, 2012

This article appears in the May 2012 issue of HealthLeaders magazine.

Aetna Inc. is developing commercial ACO and ACO-like relationships with several providers. The company has 10 agreements in place and expects to have a total of 20 under contract by the end of 2012, says Charles D. Kennedy, MD, CEO of aligned care solutions for Aetna.

The ACOs are each centered on a healthcare delivery system, hospital, or integrated delivery network. The program is in its infancy—it's been in the works for about four years but just began contracting in 2011. The diversified healthcare benefits company wants to develop a national ACO network over the next five years.

Aetna is investing in excess of $1 billion in a variety of capabilities to support its ACO business, including last year's acquisition of Medicity, a health information exchange technology company.

Kennedy is straightforward when asked why Aetna is developing this business line. "What we get out of this arrangement is growth. Health plans are in a low-margin, high-volume business. What they get is a business partner that can help them improve their margins, improve their market share, and improve the quality of care that they provide."

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2 comments on "Aetna Building National ACO Network"

T. Stanley (5/22/2012 at 10:07 AM)
What a bargain! An insurer, whose best interest is maximizing profit and reducing care, provides an "end-to-end" solution, integrating care coordination, customer service, call center and all of the back office for providers. Joy. Soon, we can get rid of the providers too, so as not to impede the "delivery" of health-care. This is thinly-varnished fraud, and about as distant from sound policy as possible. Consumers AND providers need to ring the alarm bells loudly and send this movement back to the drawing board before it's curtains for quality and good outcomes for health care in this country.

Mike Barrett (5/17/2012 at 8:28 AM)
All that was old shall be new again.... [INVALID]d, new communication technology, better understanding of care coordination, root cause analysis, and other advances - at the core this is a reflection that the provider delivery system (version 2.0) is gaining a measure (from small to large) for a population vs. individual. The old - insurance companies worried about population costs, providers worried about treatment of an individual. The new - services companies (old insurance companies) operate call centers, accounting operations, data centers, sometimes provide capital - sometimes not. Providers are now balancing the finite resources for the population with efficacy of treatment for the individual. I agree this is a massive change, and massive organizations have difficulty with massive change. Is it inevitable that there will be massive, monolithic systems in health care? It would be wise to check this assumption thoroughly - particularly in other parts of the world where costs are dramatically lower, and there are not monolithic systems.....




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