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Aetna is latest insurer to partner with Aledade on ACO-focused care

Aetna gains in-network access to independent practices, health centers and clinics that are part of Aledade's ACOs in three states.

The latest partnership between ACO-focused healthcare IT firm Aledade and an insurer is an agreement with Aetna to expand value-based primary care offerings in Delaware, West Virginia and Utah.

The agreement gives participating physicians new opportunities to share in healthcare savings if they deliver improved outcomes at lower costs.

The partnership will also expand Aetna members' access to independent practices, health centers and clinics that are part of Aledade's Accountable Care Organizations in those three states. Aledade ACOs' value-based offerings include primary care, preventive services, care coordination and population health management.

In Delaware and West Virginia, the agreement will cover Aetna's commercially insured patient centered medical home and Medicare Advantage members who see Aledade ACO physicians. In Utah, it will cover MA members.

WHY THIS MATTERS

The partnership comes as value-based care initiatives continue to ramp up. For example, late last month saw the announcement of a new set of value-based care payment models--the CMS Primary Cares Initiative--from the U.S. Department of Health and Human Services the and Centers for Medicare and Medicaid Services.

Value-based care is seen as highly beneficial and even necessary, especially in states with poor overall health outcomes such as West Virginia.

THE TREND

The Aledade-Aetna agreement is just the latest in a series of partnerships between ACOs and payers, as both groups seek to create new market opportunities. In the past five months, for example, Aledade has struck a similar three-state deal with Humana as well as a partnership with Blue Cross and Blue Shield of North Carolina.

ON THE RECORD

"We are delighted to introduce this new partnership to both our commercial and Medicare members, and encourage them to seek their health care through this physician-led care model," said Martha Carlson, chief network and operations officer for Delaware and West Virginia. "Through accountable care relationships, we're working closer than ever with physicians and hospitals to make healthcare more affordable to both our members and providers, while also improving quality and efficiency."

"We are excited to partner with Aetna to bring this model of care to more patients, and we look forward to growing this multi-state partnership," said Dr. Farzad Mostashari, chief executive officer and co-founder of Aledade.
 

Mark Klimek is an independent writer and editor with 20 years' experience covering financial issues, healthcare and more.

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