Aetna and The Children’s Hospital of Philadelphia (CHOP) have announced a new accountable care organization (ACO) collaboration designed to improve the quality of care and lower health care costs through more coordinated care. This is Aetna’s first pediatric ACO arrangement.
ACO Agreement Details
Under the contract, members of Aetna commercial plans (up to age 19) in the five-county Philadelphia area and Burlington County, N.J., and who receive care from CHOP physicians, became part of the program. The agreement is part of Aetna’s strategy to transition from fee-for-service reimbursement to value-based payment.
The agreement features a new payment model that rewards physicians for meeting certain measures designed to improve quality, lower costs and improve patient satisfaction. Examples include reducing potentially avoidable hospital admissions and emergency-room visits, and improving appropriate antibiotic usage. More than 1,100 CHOP physicians will be part of this new model. Aetna provides health benefits to nearly 1.4 million members in Pennsylvania.
Emerging Value-based Arrangements
Value-based arrangements are emerging as a solution to address rising health care costs, reduce duplication of services, improve health outcomes, and make it easier for people to get the care they need. In value-based models, doctors and hospitals are paid for helping keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.
“The Children’s Hospital of Philadelphia is committed to exploring new and innovative relationships that enable families throughout our service area to benefit from the world-class pediatric care that they can only receive at CHOP,” said Matthew Cook, executive vice president of strategic planning and business development, at The Children’s Hospital of Philadelphia. “This agreement with Aetna will be of great benefit to their subscriber families and we are gratified to join Aetna in this effort.”
