Aetna Engages in Broadscale Medical Home Program

Aetna joined the Centers for Medicaid and Medicare Services (CMS) Innovation Center and 500 primary care physicians nationwide in launching a sweeping new medical home program set to begin this fall. The multi-year Comprehensive Primary Care (CPC) initiative aims to improve the quality and cost of health care by improving millions of Americans' access to excellent primary care.

"Aetna is proud to support the CPC initiative. We will learn more about the model's success in improving care quality while reducing aggregate health care costs," said Elizabeth Curran, head of Aetna's National Network Strategy and Program Development. "We also expect to gain key insights into how payers and doctors can work together to deliver more effective health care for members. We believe this program will provide extensive testing and growth of technologies used to manage health care and track clinical results. This collaboration is a natural progression of our efforts to better align payments to improved population health."

The CPC initiative includes the participation of private health plans, state Medicaid agencies, and other payers in Arkansas, Colorado, Oregon, and New Jersey. In addition, the Capital District-Hudson Valley region of New York, Ohio and Kentucky's Cincinnati-Dayton region, and Greater Tulsa Oklahoma are participating. Earlier this year, the CMS Innovation Center selected Aetna to participate in both the New York and Ohio-Kentucky regions. Aetna will immediately begin contacting the practices selected by CMS to participate in the program. The program will launch on November 1, 2012 for Aetna members and other patients.

Under the Comprehensive Primary Care Initiative, CMS will pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. Simultaneously, participating commercial, state, and other federal insurance plans are also offering enhanced payment to primary care practices that are designed to support them in providing high-quality primary care on behalf of their members. The commercial payers are in the process of determining participation and payment arrangements. Both Medicare and commercial membership will be eligible.