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Aetna Introduces Multi-Physician Group Accountable Care Collaboration in Colorado

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Aetna (NYSE: AET) today announced an accountable care collaboration with Banner Network Colorado, Colorado Health Neighborhoods, New West Physicians and Physician Health Partners, along with the introduction of the Aetna Whole HealthSM product in Colorado. Aetna Whole Health is a product offering designed to give members in Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer and Weld counties access to highly coordinated care from multiple physicians and facilities along the Colorado “Front Range.” The product will be available for self-insured and fully insured customers starting on January 1, 2015.

An accountable care collaboration is a group of health care providers who assume responsibility for the quality and cost of care for a group of patients. Aetna members will receive an enhanced level of coordinated care in addition to the member benefits of their current Aetna plan.

The combined Aetna Whole Health – Colorado Front Range network will provide Aetna members access to more than 800 primary care physicians, 4,000 specialists and 31 hospitals throughout the Colorado Front Range.

“Aetna is a leader in the industry when it comes to product model accountable care collaborations,” said Tom Dameron, Aetna’s president for Colorado. “By working with Banner Network Colorado, Colorado Health Neighborhoods, New West Physicians and Physician Health Partners, we are redefining the relationship between insurers and providers. The end result will be better, more efficient and more affordable care for our members and customers in Colorado.”

“We are pleased that Banner Network Colorado has been selected by Aetna to serve the members of Aetna Whole Health in Larimer and Weld counties,” said Paul Kellogg, senior director for managed care in Banner Health’s Western Region. “The arrangement between Aetna and BNC is designed to enhance care and control costs through an emphasis on wellness and close coordination of care for members. Banner Health Network’s program with Aetna and its Aetna Whole Health product in Arizona has shown tremendous success for its members, and we’re confident we will see the same successful outcomes in northern Colorado.”

The accountable care collaboration gives employers better health care options for their employees, and will feature a new model of health care delivery designed to offer:

  • Cost savings to employees who use providers in the Aetna Whole Health- Front Range network;
  • A more coordinated, personalized experience for patients; and
  • Better health care outcomes.

“Colorado Health Neighborhoods is pleased to join with Aetna on an ACO that will deliver high-quality health care value to our mutual consumers in Colorado,” said John Suits, executive director, Colorado Health Neighborhoods. “We are particularly excited about the early 2015 launch of Aetna’s Whole Health – Colorado Front Range product. Colorado Health Neighborhoods will serve as a provider network and is in the position to offer coordinated care that will benefit consumers.”

New payment agreements reward improvements in quality and costs of care

The agreement features a new payment model to reward 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.

“Aetna’s ACO product was thoughtfully designed, reflecting the needs and learnings of early ACOs in the local marketplace,” said Ruth Benton, New West Physicians’ CEO. “New West has great hopes that Aetna can grow their Denver presence through this innovative product.”

“Our physicians and staff are excited to collaborate with Aetna to bring our care management and quality programs to thousands of people in the Denver metro area,” said Kenneth Nielsen, President and CEO, Physician Health Partners. “We believe in accountable care and look forward to seeing what we can accomplish this relationship.”

Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care for all health care consumers. Nationally, more than 2.3 million Aetna members are served by value-based health care models.

About Banner Network Colorado

Banner Network Colorado (BNC) is a provider network serving health care policyholders in Larimer and Weld counties in northern Colorado’s Front Range. The network is composed of health care providers such as physicians, hospitals and related medical providers who are linked together to improve the quality of care for patients. These providers make a commitment to work closely together to coordinate all aspects of a patient’s care, to enhance the patient experience and to improve outcomes. More than 300 providers are currently participating in Banner Network Colorado.

About Colorado Health Neighborhoods

Colorado Health Neighborhoods is Centura Health’s physician-led network of providers comprised of more than 2,500 employed and independent affiliated physicians dedicated to developing a clinically integrated network that delivers optimal health care value to consumers and the communities served. Colorado Health Neighborhoods is creating a system that promotes proactive coordination among providers to produce demonstrably improved health outcomes at an affordable cost in a more convenient, service-oriented setting. Leveraging a partnership with Centura Health, the region’s leading health care network, Colorado Health Neighborhoods has the resources to deliver on its vision for the future of health care. For more information, visit www.coloradohealthneighborhoods.org

About New West Physicians

New West Physicians is one of the largest, privately owned primary care physician groups in Colorado and has grown to 17 offices located throughout the Denver Metro area. Sixteen of our seventeen offices are Patient Centered Medical Home (PCMH) certified Level 3 and all eligible providers are National Committee for Quality Assurance (NCQA) recognized for Heart/Stroke and Diabetes. In 2013, New West Physicians received the Patient Centered Medical Home (PCMH) Best Practice of the Year Award by the Colorado Academy of Family Physicians Foundation. Our integrated team of board certified family practice and internal medicine physicians, hospitalists, cardiologist, gastroenterologist, physician assistants, and nurse practitioners are committed to providing excellent service to every patient…every time. Our embedded Diabetes and Nutrition Center and Behavioral Health Services program are an excellent resource for patients. Visit our website to learn more www.nwphysicians.com

About Physician Health Partners, Primary Physician Partners and South Metro Primary Care

PHP is owned and operated by primary care physicians, including physicians in Primary Physician Partners (PPP) and South Metro Primary Care (SMPC), and was founded in 1996 as a management services organization. PHP collaborates with more than 300 primary care providers in the Denver metro area and manages two adult and one pediatric independent practice associations (IPA) that are involved in several ACO initiatives. Additionally, PHP manages Colorado Community Health Alliance, the regional care collaborative organization for Colorado Medicaid region 6. PPP is a primary care IPA comprised of family practice, internal medicine and geriatric physicians located throughout the metro Denver area with concentrations in the north and western areas. This IPA, in existence since 1996, was originally formed from Northern Health Partners and Superior Health Systems. SMPC is a primary care IPA comprised of family practice and internal medicine physicians located mainly in the southwest and east Denver metro areas. SMPC has been in existence since August 2007 and in 2012 merged with another IPA, KEY Primary Care Physicians.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 45 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @aetna

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