Aetna and Optimus HealthCare Partners Offer Accountable Care to Aetna
From the primary care physician’s office to specialists and facilities,
patients will enjoy a more coordinated health care experience
FAIRFIELD, N.J. and SUMMIT, N.J. -- January 17, 2013
Aetna (NYSE: AET) and Optimus HealthCare Partners today announced a new
accountable care agreement in New Jersey. The agreement is the only one
between Optimus and a health plan to include Optimus primary care, pediatric
and specialist physicians. The agreement is designed to improve the quality of
care for Aetna members and lower overall health care costs.
Aetna members covered under fully insured plans as well as Aetna Medicare
Advantage members in Union, Somerset, Essex, Middlesex, Monmouth, Ocean,
Warren, Morris and Hunterdon counties are included.
“We are pleased to be working with Aetna through an accountable care
arrangement that focuses on the triple aims of improving patient satisfaction,
improving patient outcomes, and doing this in a cost-efficient manner,” stated
Dr. Thomas Kloos, president and CEO of Optimus. “Our physicians have had a
long-standing, collaborative relationship with Aetna. This is the next
evolution. We look forward to working closely together.”
John Lawrence, president of Aetna’s New Jersey operations, said, “We are
excited about this unique agreement with Optimus. We know it will make the
health experience better for our New Jersey members. Optimus physicians will
ensure that no matter what their health care needs may be, our members will
receive more outreach and coordination to make the entire experience simpler
and more effective.”
The Optimus accountable care model is available now to the approximately
11,900 fully insured Aetna members who received care from Optimus physicians
in the last 24 months. In addition, Aetna is implementing a Medicare Provider
Collaboration model with Optimus to support Medicare Advantage members. Aetna
already covers 1,800 members in this type of agreement with Vista IPA, one of
the founding organizations of Optimus Healthcare Partners. Many Medicare
members have complex health care needs. Aetna nurse case managers work closely
with physicians to coordinate and improve the care for these members and
ensure adherence to best practices and treatment plans.
In a study published in Health Affairs, Aetna’s Medicare Provider
Collaboration program was shown to:
*Significantly reduce hospital admissions and readmissions;
*Increase preventive care; and
*Reduce health care costs for the study population compared to unmanaged
In the near future, Aetna and Optimus will offer self-insured employers in New
Jersey the opportunity to participate in this accountable care arrangement for
Accountable care models drive focus on more coordinated care
An accountable care organization (ACO) is a group of health care providers who
assume responsibility for the quality and cost of care for a group of
patients. Aetna members will receive an enhanced level of coordinated care in
addition to the member benefits of their current Aetna plan.
Dr. Jim Barr, chief medical officerfor Optimus noted, "Aetna members will
receive personalized and comprehensive care. A lead physician and care teams
will closely monitor patients’ progress, engage them in their own health care
and centrally coordinate the delivery of their care with other providers. This
team-based approach extends across our network to include our subspecialist
physicians and our hospital partners."
New payment agreements reward improvements in quality and costs of care
The agreement features a new payment model to reward Optimus physicians for
meeting quality, efficiency and patient satisfaction measures, including:
*The percentage of Aetna members who receive recommended preventive care
*Better management of patients with chronic conditions such as diabetes and
*Reductions in avoidable hospital readmissions; and
*Reductions in Emergency Room visits by improving primary care access hours
and care coordination.
Aetna is working with health care organizations across the country to develop
products and services that support value-driven, patient-centered care.
Aetna’s solutions help all types of patients, regardless of payer. Information
about Accountable Care Solutions from Aetna is available at www.aetnaacs.com.
About Optimus Healthcare Partners
Optimus Healthcare Partners is an Accountable Care Organization, founded by
members of Vista Health System IPA, and Central Jersey Physician Network. In
partnership with physicians of Morris Somerset IPA and Morris Area Integrated
Physicians IPA, as well as Atlantic Health System, Optimus has developed a
physician owned and managed organization of over 160 primary care physicians
and over 370 specialists, capable of delivering the full spectrum of medical
services to its patients.Optimus is an early participant in the Medicare
Shared Savings Program, and has other commercial ACO contracts as well, now
covering approximately 80,000 beneficiaries within its high performance
Aetna is one of the nation's leading diversified health care benefits
companies, serving approximately 37.3 million people with information and
resources to help them make better informed decisions about their health care.
Aetna offers a broad range of traditional, voluntary and consumer-directed
health insurance products and related services, including medical, pharmacy,
dental, behavioral health, group life and disability plans, and medical
management capabilities, Medicaid health care management services and health
information technology services. Our customers include employer groups,
individuals, college students, part-time and hourly workers, health plans,
health care providers, governmental units, government-sponsored plans, labor
groups and expatriates. For more information, see www.aetna.com.
Photos/Multimedia Gallery Available:
Susan Millerick, 860-273-0536
Optimus HealthCare Partners
Deb Rodgers, 908-598-0101
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