Baylor, Aetna offer accountable care

09/04/2014 10:35 AM

09/04/2014 10:36 AM

Aetna, in collaboration with Baylor Scott & White, unveiled a new insurance product Wednesday in seven North Texas counties that rewards doctors based on such things as patient satisfaction, preventive screenings, and a reduction of emergency visits and hospital readmissions.

On Oct. 1, the Aetna Whole Health program will cover insured people whose employers have contracted self-funded programs administered by Aetna. Employers who buy Aetna insurance will be covered by the new program early next year, Aetna said.

The new program uses 900 primary-care physicians, 27 hospitals, 2,800 specialists and six urgent-care facilities in Tarrant, Parker, Denton, Collin, Dallas, Ellis and Rockwall counties

Patients will deal with what’s called an accountable-care collaboration — a consortium of healthcare providers who assume responsibility for the quality and cost of care for groups of patients. Customers will receive “an enhanced level of coordinated care in addition to the member benefits of their current Aetna plan,” Aetna said.

“By working collaboratively with organizations such as Baylor Scott & White Quality Alliance, we are changing the healthcare system to focus on quality and affordability while ensuring that our members receive care that helps them live healthier, more productive lives,” said Ralph Holmes, Aetna’s president for North Texas.

Dr. Carl E. Couch, president of Baylor Scott & White Quality Alliance, said Baylor and Aetna share a goal of “improving quality, reducing cost and clinically integrating for the populations that we mutually serve.”

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