Aetna and St. John Health System, a part of Ascension, the nation’s largest Catholic and nonprofit health system, today announced a collaboration to launch Aetna Whole Health St. John OKHI in Tulsa County. This new health care product enables doctors to deliver highly coordinated care, track outcomes through shared data, and measure clinical standards to improve quality and efficiency.
As part of Aetna Whole Health St. John OKHI, Aetna members will receive coordinated care through Tulsa-area St. John hospitals and more than 500 primary care physicians and specialists that are part of the St. John accountable care organization, Oklahoma Health Initiatives (OKHI).
Aetna Whole Health St. John OKHI will be available to self-insured and fully insured businesses effective July 1, 2016, and to small businesses from October 1, 2016.
Aetna Whole Health St. John OKHI members will see:
– Coordinated, team-based care among doctors and other care providers;
– Enhanced patient experience through high-quality care management programs and technology that delivers information to all providers;
– Lower overall out-of-pocket costs for members who see providers that are part of Aetna Whole Health St. John OKHI; and
– Better health care outcomes.
New payment agreement to reward improvements in quality and cost of care
The agreement rewards achievement of quality and efficiency measures, including:
– The percentage of Aetna members who receive recommended preventive care and screenings;
– Better management of patients with chronic conditions such as diabetes and heart failure; and
– Decreasing avoidable emergency room visits and hospital readmissions through the proactive management by care teams.
St. John’s accountable care organization (ACO), named Oklahoma Health Initiatives (OKHI), launched in January 2014 as Oklahoma’s first ACO and is a collective of both St. John and affiliate providers. OKHI works with the Centers for Medicare & Medicaid Services to maintain and follow a plan that meets the required operational elements of establishing, reporting and ensuring compliance with health care quality criteria to better serve Medicare beneficiaries and other populations attributed to ACO providers.
Aetna works with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. Nationally today, about 6.2 million Aetna members receive care from doctors committed to the value-based approach, with about 40 percent of Aetna claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 75 percent by 2020.