Relationships with accountable care organizations and provider organizations can help payers join in a value-based, holistic approach to improving health within a community, said Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.
Relationships with accountable care organizations (ACOs) and provider organizations can help payers join in a value-based, holistic approach to improving health within a community, said Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.
Transcript (slightly modified)
How do value-based payments better address the care needs of patients with complex health needs compared with traditional fee-for-service?
There are a number of different ways that we have value-based relationships with provider organizations. At the present time, we have approximately 280 ACO relationships, the formation of accountable care organizations. Each of those is unique to the population that’s being served, because the emphasis really is on the population health and community-based initiatives, and looking at a holistic approach to improving health status for individuals in the community.
But beyond that, we even have joint venture partnerships with the provider organizations. We have 3 right now that we’ve announced, that are underway, and we have others that are being reviewed and are in formation. And in a joint venture relationship, our first was with Inova Health, we have a 50/50 joint venture. We create a health insurance enterprise with our partner to allow them to take the risk, to allow them to care for a population and look at a broad view of care across a continuum for individuals.
The goal, again, is to emphasize the outcomes, the quality, the improved health status, to emphasize wellness, and to make sure that the right care is delivered at the right time and the right place for each individual in that community.