Aetna Adapts to Changing Healthcare Market by Embracing ACO Model

Aetna’s Targeted ACO Strategy Positions the Company for Health Reform, According to HealthLeaders-InterStudy

NASHVILLE, Tenn.--(BUSINESS WIRE)--HealthLeaders-InterStudy, the leading provider of managed care market intelligence, finds that Aetna is adapting to the changing healthcare market by focusing on key markets and embracing the Accountable Care Organization (ACO) model. This strategy will help the company thrive in a post-reform healthcare landscape. Aetna’s ACO strategy is likely to pay off if the company can better control costs by coordinating care, according to the National MCO Analyzer: Aetna report.

“By offering co-branded health coverage products with its ACO partners, Aetna is creating a new twist on vertical integration that does not rely on health plan ownership of the physician group or hospital”

Aetna’s Accountable Care Solutions division offers IT, risk management, analytics and organizational expertise to provider groups that want to operate ACOs. Aetna’s ACO collaborations in Arizona and Virginia offer Aetna Whole Health co-branded health plans and low cost narrow-network products. Aetna’s ACOs will set their own performance measures and incentives around cost savings and clinical quality but medication adherence will be a major focus.

“By offering co-branded health coverage products with its ACO partners, Aetna is creating a new twist on vertical integration that does not rely on health plan ownership of the physician group or hospital,” said HealthLeaders-InterStudy Principal Analyst Paula Wade.

Aetna’s involvement with ACOs will run the gamut from an IT provider and management partner to the formation of a joint venture that creates an ACO with risk-sharing and a new Medicaid MCO.

The National MCO Analyzer: Aetna answers the following questions:

• What is Aetna doing to make sure it can offer healthcare products at a competitive price when it cannot win the deep provider discounts that its larger market competitors can?
• How is Aetna allowing plan sponsors to customize benefits to encourage prescription compliance?
• What will the likely effect be in the markets where the Aetna ACO collaborations exist?

Click here to view an abstract of the report: http://tinyurl.com/843tey6

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a Decision Resources Group company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com. HealthLeaders-InterStudy is part of the Market Access Business Unit at Decision Resources Group which also includes Fingertip Formulary, Pinsonault and PharmaStrat.

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