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Home / News & IndustryManaged Care Insight and Analysis
Updated: Feb. 24, 2009
Aetna And Partners In Care Test New Approach To Healthcare Services

Aetna and Partners In Care Corp. (PIC) said they have launched a pilot program to test a new healthcare model that will make the healthcare system an easier place for patients.

Called a "Patient-Centered Medical Home" the model emphasizes the role of the primary care physician (PCP) in managing and coordinating patient care across a range of care providers, including specialists and hospitals.

"Patients, physicians and health benefits companies all want the healthcare system to be easier for people, less repetitive and more effective," said Dr. Thomas Howe, Aetna’s medical director in Northern New Jersey. "We can provide valuable tools and information to support both members and physicians, but this medical home model enhances the role of primary care physicians, enabling them to more effectively coordinate and follow-up on the care of each patient, across a group of caregivers, and make sure that the quality and efficiency of care received by these patients are excellent."

The PIC PCPs, assisted by the PIC Care Coordination Entity, will receive reimbursement for the extra services they provide to coordinate care in a way that improves healthcare efficiency and makes getting needed services much easier for patients.

Under the new agreement, Aetna and PIC will focus on improving overall care for patients with chronic illnesses such as diabetes, hypertension and asthma employing the skills and capabilities offered by both organizations in a coordinated fashion. Specifically, Aetna and PIC will:

  • Implement a medical home model which places the patient’s personal physician in charge of all the patient’s care needs, including arranging and tracking care with other qualified professionals at all stages including acute care, chronic care, preventive services and even end-of-life care services;
  • Use the PIC-developed "Physician-Guided Care Coordination" approach to care. Aetna will reimburse the PCP for taking time to make sure that all of the patient’s caregivers are aware of and following the treatment plan prescribed by that PCP; and
  • Provide physicians with detailed clinical data provided by Aetna Health Analytics and through its subsidiary ActiveHealth Management, to identify changes that may be needed and to help assure that the patients receive the right care at the right time and place.

The patient-centered medical home concept of care has been under development since the mid-90s and is based on a patient having an ongoing relationship with a personal physician trained to provide first contact and continuous, comprehensive care. This personal physician leads a team of care providers at the practice level who collectively take responsibility for the ongoing care of patients, looking beyond the walls of their own office, and communicating with the patient’s other providers to assure the treatment plans are followed. The concept is designed to nurture and strengthen the relationship between the patient and physician.

Addresses: Aetna, 151 Farmington Ave., Hartford, CT 06156; (860) 273-0123, www.aetna.com. Partners in Care Corp., 2 Tower Center Blvd., Tower Center II, 12th Fl., East Brunswick, NJ 08816; (732) 246-0291, www.piccorp.com.


  This article was taken from:
The Executive Report on Physician Organizations

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