Aurora Health, Aetna partner on ACO collaborative

By Erin McCann
10:23 AM

Officials at Milwaukee, Wis.-based Aurora Health Care announced on Thursday they are forming an accountable care collaboration with Aetna, Inc., an effort aimed to provide employers with a new health plan created to improve employee health outcomes while controlling costs.    

According to Aurora officials, their accountable care network offers a price guarantee to employers built upon a healthcare model that improves quality, outcomes and the patient experience. This type of price guarantee is one of the first among accountable care models. Employers are expected to see savings in their healthcare spending as a result of improved patient outcomes and greater efficiencies. 

Officials say these cost savings will be specific to each employer, with the potential for an average 10 percent reduction based on the employer's past claims expenses. The plans with Aetna will be effective beginning January 2013.

[See also: Aetna collaboration puts IT to work toward ACO goals.]

"This is a game changer," said Nick Turkal, MD, Aurora Health Care's president and CEO. "We are pleased to collaborate with Aetna to make our accountable care model available to the commercial health insurance market. As an employer, we have met national quality benchmarks among our own employees, while curbing our healthcare costs. Now we aim to replicate this success for others."

Mark T. Bertolini, Aetna chairman, CEO and president, said, "We are building on our strong provider relationships to establish a nationwide accountable network that offers better care at a lower cost for everyone. The “patient care model will lead to a better overall healthcare experience," continued Bertolini. 

[See also: Aurora Health Tweets knee replacement surgery.]

The Aetna plans offered through the Aurora Accountable Care Network are designed for Wisconsin small and mid-sized businesses. Solutions for large, self-funded employers are also available. 

The accountable care collaboration is designed to provide:

  • a more coordinated, personalized experience for patients;
  • lower co-pays for seeing Aurora Accountable Care Network providers; and
  • better healthcare outcomes.

The Aurora Accountable Care Network includes an integrated system of more than 1,500 physicians, 15 hospitals and 160 clinics in eastern Wisconsin and northern Illinois.

Employees also will have access to care managers, who can schedule appointments, help patients connect with physicians and follow up with patients who have chronic or complex conditions, officials say. This additional support is enhanced by Aurora's system-wide electronic medical records and real-time claims analysis.

Aurora has 15 years of experience with such efforts. As an employer with 48,000 covered lives, Aurora officials say they have successfully bent the cost curve. Its per-member-per-month costs decreased 2.4 percent in 2010 compared to the national average that has been rising 10-to-12 percent annually.

Between 2001 and 2010 costs for the Aurora employee health plan rose 6.2 percent per year on average, well below the national average that increased 10.7 percent a year.

Between 2008 and 2010 the plan's costs rose 1.5 percent annually, in comparison to the national average increase of 9.0 percent. 

[See also: ACOs and meaningful use to go hand in hand.]

"Aetna views accountable care organizations as a model for making healthcare work better for everyone," said Bill Berenson, Aetna market president. "Aurora has demonstrated it can improve outcomes through how it integrates patient care and implements best practices. Together with Aurora, Aetna will offer more affordable and more personalized health benefits to Wisconsin employers and their employees. This is the future of healthcare." 

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