Aetna is going forward with an accountable care agreement for some 28,000 people, partnering with a health system that also has accountable care contracts with some competitors.
The company has inked a deal with Atlantic Health System in northern New Jersey to partner with the health system's existing ACO that was established back in 2012.
Aetna members who use the Atlantic ACO and Centers of Excellence will experience more coordinated care, particularly patients with chronic or complex conditions, and will also benefit from the improved flow of information to treating physicians in the Atlantic ACO.
"When hospitals and health plans work together, health care improves for the people we serve," said John Lawrence, president of Aetna New Jersey, in a March 11 press statement announcing the deal.
"Aetna will work closely with the ACO physicians to identify specific areas where we can either develop or improve on the sharing of specific, useful health information. In turn, the physicians will use this information to improve care for patients, close gaps in care and reduce waste. We are creating a continuous loop of improved information to drive better care."
This agreement, officials pointed out, includes a shared savings model that rewards Atlantic ACO docs for meeting certain quality and efficiency measures, including: the percentage of Aetna members who receive recommended preventive care and screenings; better management of patients with chronic conditions such as diabetes and heart failure; reductions in avoidable hospital readmission rates; and reductions in unnecessary emergency room visits.
Early last year, Cigna also announced a partnership with Atlantic Health System in an ACO agreement, which reached some 15,000 patients.
Accountable care organizations currently serve some 14 percent of the U.S. population, according to a 2013 report from Oliver Wyman, with the Centers for Medicare and Medicaid Services reporting they had 366 total Medicare ACOs last December, up from 159 in summer 2012.
Despite the surge in the number of both private and federal ACOs, many contracts are not actually true fee-for-value, said Rick Weil, partner in Oliver Wyman's health and life sciences practice group, in announcing the report last year. "Most ACOs today are still mixed models, with some patients being served through ACO-style or capitated contracts and some through more traditional fee-for-service contracts," he explained. "It can take several years to shift an entire population from one model to another. But that total number of patients served by these mixed organizations is still important."