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.