The agreement features a new payment model to reward Hill Physicians and Dignity Health 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.
This agreement affects Aetna’s group market; the insurer withdrew from California’s individual health insurance market as of 2014.
The move follows by two weeks the unveiling of an individual market Accountable Care Organization (ACO) formed by Anthem Blue Cross and 6,000 doctors and 14 hospitals across seven Southern California health systems.
Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email