As healthcare increasingly rewards quality and value in care delivery, Aetna hopes that 75% of its payments will be value-based by 2020, according to Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.
As healthcare increasingly rewards quality and value in care delivery, Aetna hopes that 75% of its payments will be value-based by 2020, according to Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.
Transcript (slightly modified)
What has been Aetna’s experience with alternative payment models? What is the ultimate goal?
Aetna has been putting a great deal of emphasis in our strategic plan over the past several years on value-based relationships with providers, with hospitals, health systems, and physicians. At the present time, about 45% of our payments are through some type of a value-based relationship. Our goal is by 2020 to get to 75% of our payments in some type of a value relationship, and only about 25% will be in traditional fee-for-service reimbursement models.
We believe that’s the direction that healthcare is heading and the financing of healthcare will result in the providers of care taking more risk, on not only the outcomes but also how care is ultimately delivered to each and every individual. At the end of the day, that rewards quality, it puts the emphasis not on volume but on value, and we think that’s very important.
Increasing Lp(a) Awareness for Better Cardiovascular Health: Dr Mary McGowan
March 24th 2024For Lp(a) Awareness Day, Mary McGowan, MD, FNLA, chief medical officer of the Family Heart Foundation, highlights how most people with elevated Lp(a) are completely unaware that they have this increased risk and calls for increased testing.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Covered Preventive Services at Risk: V-BID Summit Breaks Down the Braidwood v Becerra Case
March 20th 2024For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
Read More
Reducing Low-Value Care Is Hard, but What About Just Not Paying for It?
March 14th 2024After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.
Read More
Evolution of HDHPs With VBID Components Can Improve Care for Chronic Disease
March 14th 2024Over the course of the last 20 years, high-deductible health plans (HDHPs) have undergone an evolution. Today’s plans, with more high-value services covered predeductible, can improve care for people with chronic diseases, said panelists at the 2024 Value-Based Insurance Design (V-BID) Summit.
Read More