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Modernizing Florida’s Healthcare Delivery System. Chris Day, Chief Strategy Officer Accountable Care Solutions from Aetna. Aetna’s values drive ACS s trategy. apple. The time for change is now. apple. ACS from Aetna provider collaborations

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modernizing florida s healthcare delivery system

Modernizing Florida’s Healthcare Delivery System

Chris Day, Chief Strategy Officer

Accountable Care Solutions from Aetna

the time for change is now
The time for change is now.

apple

ACS from Aetna provider collaborations

are enhancing the patient experience, improving quality of care and reducing costs by:

  • Empowering providers with an optimal technology infrastructure
  • Aligning incentives
  • Establishing scalable business models

to support market share growth and high-quality care delivery to larger populations

about acs from aetna
About ACS from Aetna.

apple

apple

  • Leveraging 160 years of experience and expertise
  • Collaborating with providers to help them in the transition to value-based care delivery models
  • Delivering technology and services that fill gaps in provider readiness for accountable care
  • Providing ongoing support through a collaborative approach
  • Delivering results
population health management is complex
Population Health Management is Complex

Who is in need of preventive care and wellness counseling?

apple

Who is failing to fill prescriptions?

Who is over utilizing the ER?

?

Who is unnecessarily driving up costs?

Who is non-compliant with diabetes treatment?

Who is overdue for important preventive testing?

accountable care solutions provides clarity and insight
Accountable Care Solutions Provides Clarity and Insight

apple

At risk for second heart attack

Behind on a year’s worth of prescription refills

Visited the emergency department five times

but missed primary care appointments

Only 17% compliant with prescribed diabetes medications

Overdue for a mammogram

Visiting 3 specialists for the one chronic condition

aetna and novahealth collaboration
Aetna and NovaHealth Collaboration
  • Background
  • Since 2008, NovaHealth doctors participating in Aetna’s Medicare Provider Collaboration program have provided care to Aetna Medicare Advantage members
  • Collaboration Goal
  • Improve quality of care and lower health care costs
  • Results
  • 50% fewer inpatient hospital days*
  • 45% percent fewer hospital admissions*
  • 56% fewer readmissions*
  • More than 99% of patients visited their doctors in 2011 to receive preventive and follow-up care
  • 16 - 33% lower PMPM costs for Aetna Medicare Advantage members vs. Aetna Medicare Advantage members not cared for by NovaHealth

apple

  • Payer-Provider Collaboration In Accountable Care Reduced Use And Improved Quality In Maine Medicare Advantage Plan
  • HealthAffairs
  • September 2012

* Compared to unmanaged Medicare populations statewide

how we help providers
How we help providers.

apple

Increase market share

  • Deliver a better patient experience to retain and grow the patient population
  • We offer affordable, network-based health plans that can be co-branded
  • Improve physician alignment across community
  • Build sustainable business models
    • Enabling scalability to help providers deliver care to larger populations
    • Supporting participation for CMS incentives
    • Establishing business models that helps in negotiations with other payers
  • Improve outcomes
    • Meet quality measures that help patients stay healthy and avoid more extensive, costly care
    • Allow patients to take an active role in their care resulting in healthier lifestyles
    • Steer patients to the right type of care based on their specific health needs