Aetna is partnering with an oncology practice in Pennsylvania to offer members seeking cancer care a patient-centered medical home network, and to offer clinicians a decision-support application.
Aetna has inked a new value-based reimbursement agreement with Consultants in Medical Oncology and Hematology, a four-location practice network affiliated with Main Line Health System and Crozer-Keystone Health System, to provide coordinated care for Aetna's commercially insured members in southeastern Pennsylvania.
"Given the frequency of contact, oncologists are in a prime position to help their patients navigate the healthcare system to get appropriate and aligned treatment for all of their conditions," Michael Kolodziej, MD, Aetna's national medical director for oncology, said in a media release.
Along with shared decision making and coordinated care, the Consultants in Medical Oncology and Hematology practice focuses on managing symptoms and side effects to reduce emergency room visits and hospital admissions.
The medical practice offers cancer treatment at several locations in greater Philadelphia, including the Delaware County Memorial Hospital, the Crozer Keystone Regional Cancer Center and the Main Line Health Center.
John Sprandio, MD, physician-in-chief at the oncology practice, and chief of medical oncology and hematology at Delaware County Memorial Hospital, said in a media release that the "model supports clinical decision making at each patient interaction, merges care processes, workflow, documentation and communication."
As part of the program Consultants in Medical Oncology and Hematology will be using an oncology decision-support software app from the Philadelphia-based company eviti and made available through Aetna's iNexx platform, designed to "reduce variability in cancer care by speeding the identification and use of evidence-based, clinical best practices" and also to automate the preauthorization process for physicians.
Although the deal does not cover Medicare Advantage beneficiaries, Aetna's Kolodziej said the patient centered medical home in oncology has a lot of potential for seniors -- who represent more than half of all new cancer patients and also have one or more chronic conditions.
"Proactive outreach and engagement are the first lines of defense in avoiding complications of cancer treatment as well as other chronic diseases," he said.
Editor's note: A previous version of this article erroneously stated that the eviti software was developed at Aetna's Innovation Labs.