AETNA FORMS PRODUCT-BASED ACCOUNTABLE CARE ORGANIZATION WITH GATEWAY HEALTH
Posted on Monday, July 18, 2016
DANVILLE, Va., July 13, 2016 — Aetna (NYSE: AET) and Gateway Health today announced a commercial, product-based accountable care organization (ACO) agreement designed to enhance coordinated patient care, lower health care costs and improve the patient experience.
The ACO brings together Gateway Health, Memorial Hospital of Martinsville and Henry County, and Danville Regional Medical Center, to form a robust network of doctors and hospitals. The network offers every level of health service, from prevention and primary care to the most sophisticated specialty services.
“Aetna is working to transforming the health care system, putting consumer needs first,” said Mike Bucci, president of Aetna’s operations in Virginia, Maryland and Washington, D.C. “Our new agreement with Gateway Health promotes wellness, provides better care for patients with chronic conditions and uses economic incentives to reward positive health outcomes.”
The new commercial health care plan, to be called Aetna Whole Health–Gateway Health, will be available for large-group and small-group customers this fall for an effective date of Jan. 1, 2017. Aetna and Gateway Health also will introduce a new individual insurance product, called Aetna Leap, to be available on Healthcare.gov in time for the 2017 open enrollment period,.This consumer-based suite of products will include member incentives for healthy living, as well as plans developed specifically for persons with chronic conditions like diabetes and depression. The ACO service area includes the cities of Danville and Martinsville, as well as Henry and Pittsylvania counties.
“Through our unique arrangements with local providers and our dedication to member health, as evidenced by our health improvement program, Healthy Solutions by Gateway Health, we are working to ensure access to high-quality, cost-effective health care services. We are proud to work with Aetna on these initiatives,” said Brett Jackson, executive director of Gateway Health.
Aetna Whole Health–Gateway Health network plans are designed to give employers better health care options for their employees. The value-based, patient-centric model of health care focuses on keeping people healthy rather than just treating them when they become sick.
The plans feature a new model of health care delivery designed to offer:
- More coordinated, team-based care among doctors and other care providers;
- Enhanced patient experience through best-in-class care management programs and technology that delivers actionable information to providers;
- Lower overall out-of-pocket costs for members who see providers that are part of the Aetna Whole Health–Gateway Health network; and
- Better health care outcomes.
Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. Nationally today, about 6.2 million Aetna members receive care from doctors committed to the value-based approach, with approximately 40 percent of Aetna claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 75 percent by 2020.