Aetna is expanding its accountable care relationship with the Sharp HealthCare system, introducing a new insurance product for large group members in greater San Diego.
The Whole HealthSM health plan is aimed at creating a "more coordinated, personalized experience for patients," Aetna said in a media release, and will be available to self- and fully-insured companies with 100 employees or more in greater San Diego.
Aetna started an accountable care collaboration with Sharp Community Medical Group in December 2011, and the expansion will extend the relationship to Sharp's Rees-Stealy clinics and physicians, as well as Sharp's four hospitals and ancillary care centers.
Brian Ternan, Aetna's president for Southern California, said the new agreement's payment model ties reimbursement for Sharp HealthCare and its affiliated docs to quality, efficiency and patient satisfaction measures. Specifically, Aetna said it is expecting better chronic condition management care for patients and reductions in avoidable readmissions and emergency room visits.
Aetna has established more than 25 commercial accountable care agreements, along with 75 Medicare provider collaboration agreements. Sharp HealthCare, one of the largest health systems in Southern California, was selected as a Medicare Pioneer ACO in 2011.
While taking a very cautious approach to participation in insurance exchanges, Aetna has been embracing accountable care, another major initiative of the Affordable Care Act, since 2007, and is now offering a range of tools and services geared towards providers looking for help with population health, accountable care and business process management.
In August, Aetna announced new accountable care contracts in Maine with InterMed, MaineGeneral Health, Maine Health, Martin's Point Health Care and Mercy Health System.
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