Dive Brief:
- Cornell University's medical group, Weill Cornell Physicians, has signed an ACO deal with Aetna under which it will care for about 9,000 of the payer's New York-based commercial and Medicare members.
- The ACO will involve not only the medical group's 1,237 doctors, but also other professionals including healthcare managers who work with the payer to coordinate care.
- Under the agreement, Aetna will reward physicians in the medical group for meeting quality and efficiency benchmarks for commercial clients. The insurer will also reward improved use of medical services and communication among medical professionals for Medicare patients by using CMS quality and efficiency measures.
Dive Insight:
One thing which makes this deal interesting is that Aetna has taken care to separate how it manages commercial and Medicare patients within the ACO relationship--an unusual step in most ACO deals. In a press release, Aetna noted that many Medicare members have complex healthcare needs that go undetected, but contended that when providers and payers work together in a Medicare collaboration model, both care and direct outreach may be improved. Aetna is likely to bring this emphasis on Medicare care coordination to its other ACO deals, which currently encompass more than 2.3 million of the payer's members nationwide.
It's also striking that Aetna's ACO focus has been so strong in New York, where it has over 100,000 members served through value-based collaborative arrangements. The payer intends to bring such arrangements to 200,000 members, or about 20% of its membership by the end of 2014. It will be interesting to see whether this concentration of members in new care models in New York teaches Aetna any special lessons that may be extrapolated to the rest of its national membership.