Model of Highly Coordinated Care Begun By Aetna, Baptist Memorial Health Care

Employers and their workers will get access to what is described as highly coordinated care from physicians and facilities in the Baptist Select Health Alliance, under terms of a collaborative care agreement between Aetna and Baptist Memorial Health Care,  Memphis.

Aim of the collaboration is to bring a “new health care model” to Aetna members and introduce Aetna Whole HealthSM, a commercial health care product, officials said.

The Baptist Select Health Alliance is a clinically integrated group of physicians focused on tracking outcomes, sharing data and measuring clinical standards to improve quality and efficiency.

Aetna Whole Health plans will be offered to small and mid-sized employers for effective dates beginning July 1. Aetna Whole Health plans feature a new model of health care delivery designed to offer:

  • A more coordinated, personalized experience for patients;
  • Lower co-pays for seeing providers that are part of the accountable care network; and
  • The likelihood of better health care outcomes.

Collaborative care models seen driving focus on more coordinated care

In collaborative care models, a group of health care providers delivers more coordinated care for patients to drive better quality and lower overall costs, Aetna said. Through Baptist Memorial Health Care, Aetna members will receive an enhanced level of coordinated care in addition to the member benefits of their current Aetna plan.

Baptist Memorial Health Care, in partnership with physicians, created Select Health Alliance, believed to be the first multi-specialty integrated network in the Mid-South.

“We will be putting current data in the hands of physicians, allowing them to improve care and create a better overall value for their patients,” said David Elliott, vice president of managed care for Baptist Memorial Health Care.

Select Health Alliance physicians, along with Baptist hospital facilities, will use information technology to assist in coordinating care and in actively engaging Aetna members in maintaining their overall health. Members will receive:

  • Outreach to inform members of recommended preventive services;
  • Personalized care management and support for patients with chronic conditions; and
  • Reminders, counseling and education to foster wellness.

The collaborative agreement also includes a new payment agreement between Aetna and Baptist that features a reimbursement model to reward Baptist Select Health Alliance physicians for meeting quality, efficiency and patient satisfaction measures, including:

  • 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.
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