Aetna Building National ACO Network

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

The length of the typical ACO contract will vary depending on how much progress the delivery system has made in clinical integration and accepting risk. "For a delivery system with no clinical integration in place, we might look at a contract that runs five years or more because it's going to take a while to get everything lined up, make the governance changes, and deploy the technology."

Aetna is not looking to develop exclusive relationships with the providers. Kennedy explains that providers can't be expected to make a big investment in the technology and other systems and then only use them on a subset of their patients. "For many of our products and services, we offer them on an all-patient/all-payer basis because that's the only way to get the work flow to make sense. A provider isn't going to design one work-flow system for Aetna patients, another for Blues patients, and then another for their Medicare patients."

He says it's too early to see results from these relationships but that the response to the business model has been positive. "One surprise for us is that some national account customers with employees in Roanoke are carving out their healthcare insurance business in the area so they can send their employees specifically to Carilion."

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

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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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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