Aetna Launches ACO Partnered Plan in WA

On Thursday, Aetna introduced Aetna Whole Health to the Puget Sound health insurance market. This plan incorporates elements from affordable care organizations (ACO) and will coordinate care in King, Snohomish, and Pierce Counties. Employers can offer a choice of four major networks in the greater Seattle area: Pacific Medical Centers (PacMed), the Polyclinic, Providence-Swedish Health Alliance, and Rainier Health Network. All four include Seattle Children’s Hospital, which avoids the network adequacy debacle many plans encountered at the WA OIC.

We are excited to work with PacMed, The Polyclinic, Providence-Swedish Health Alliance and Rainier Health Network to offer an innovative health care product in the Puget Sound region. Our new Aetna Whole Health product is intended to provide our members with better health care experiences and outcomes, while helping employers manage health care costs.

Norm Seabrooks, President of Northwest Market, Aetna Press Release

The partnership features a new payment model which rewards providers for meeting quality, efficiency, and patient satisfaction measures including:

  • The percentage of Aetna members who get 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 emergency room visits.

The move forms one of the largest ACO-led plans in the United States and the largest in the Pacific Northwest market. Aetna strategy of working with health care organizations across the country to develop products and services around value-driven, patient-centered care will certainly disrupt competition in the market. Nationally, more than 2.3 million members are served by value-based health care models.

This product will be available for self-insured customers starting January 1, 2015 and for fully-insured customers in early 2015.

Click here to view the original press release.