Aetna, Mercy Health develop new health plans

A new commercial health plan is being introduced to the Cincinnati market in a partnership between the Aetna insurance company and Mercy Health network.

The Aetna Whole Health - Mercy Health network is the national insurer’s first commercial accountable care collaboration in Ohio and will offer health plans to self- and fully-insured businesses starting this summer.

Aetna Whole Health will offer highly-coordinated care among approximately 350 primary care physicians, 2,400 specialists and eight hospitals: Cincinnati Children’s Hospital Medical Centers in Cincinnati and Liberty Twp.; Mercy Health – Fairfield Hospital; Mercy Health – Anderson Hospital; Mercy Health – Clermont Hospital; Mercy Health – West Hospital; The Jewish Hospital – Mercy Health; and Select Specialty Hospital-Cincinnati.

“The Aetna plan encourages excellent primary care, preventive screenings and better care for chronic conditions than more traditional health plans,” said Yousuf J. Ahmad, market president and chief executive officer of Mercy Health. “The outcome is better health for our patients, which is what we strive for.”

Rohan Hutchings, spokesman for Aetna, said Aetna Whole Health plans feature a new model of health care delivery designed to improve health outcomes through care coordination teams and the use of electronic health records and other technology; and to lower overall out-of-pocket costs by offering a 10 percent savings to stay in-network.

“This agreement is the perfect antidote to what’s been plaguing the industry for years,” said Nitin Bhargava, president of Aetna’s Ohio operations. “The people of Cincinnati will be able to access quality health care that delivers an exceptional experience at a lower cost. Aetna’s partnership with Mercy Health will help our Cincinnati members build healthier, more productive lives.”

The new commercial plans will be available July 1 to self-insured businesses and Aug. 1 for fully-insured businesses in Butler, Warren, Clermont and Hamilton counties, according to Aetna.

The agreement will be a shared-savings program using the previous year’s claims data to determine savings in areas of quality and efficiency measures, said Nanette Bentley, spokeswoman for Mercy Health.

Those measures include decreasing avoidable emergency room visits and hospital readmissions through care-coordination teams; better management of chronic conditions such as diabetes and heart failure; and the rate of members getting recommended preventive care and screenings, according to Aetna.

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