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Aetna and Partners In Care Test New Approach to Health Care Services


New Model Creates a “Medical Home” for Patients that is Based on a Strong Primary Care Relationship and Close Coordination with Other Care Providers

Aetna (NYSE: AET) and Partners In Care, Corp. (PIC) today announced a pilot program to test an innovative new health care model that will make the health care system an easier place for patients. Called a “Patient-Centered Medical Home” the model emphasizes the role of the primary care physician (PCP) in managing and coordinating patient care across a range of care providers, including specialists and hospitals.

“Patients, physicians and health benefits companies all want the health care system to be easier for people, less repetitive, and more effective,” said Thomas Howe, MD, Aetna’s medical director in Northern New Jersey. “We can provide valuable tools and information to support both members and physicians, but this Medical Home model enhances the role of primary care physicians, enabling them to more effectively coordinate and follow up on the care of each patient, across a group of care givers, and make sure that the quality and efficiency of care received by these patients are excellent.”

The Partners In Care PCPs assisted by the PIC Care Coordination Entity, will receive reimbursement for the extra services they provide to coordinate care in a way that improves health care efficiency and makes getting needed services much easier for patients.

“Aetna’s commitment to working with the treating physicians to help build Medical Homes for those patients is impressive,” said Steven Goldberg, MD., Chairman, PIC. “This patient-centric approach will make sure that all of the patients’ caregivers are aware of and following their treatment plans. It also is consistent with our organizational goal of finding ways to support practicing physicians in their effort to improve the overall quality of care provided to their patients, and by rewarding physicians for achieving national certification standards.”

Under the new agreement, Aetna and PIC will focus on improving overall care for patients with chronic illnesses such as diabetes, hypertension and asthma employing the skills and capabilities offered by both organizations in a coordinated fashion. Specifically, Aetna and PIC will:

*" Implement a Medical Home model which places the patient’s personal physician in charge of all the patient’s care needs, including arranging and tracking care with other qualified professionals at all stages including acute care, chronic care, preventive services and even end of life care services;
*“ Use the PIC-developed ”Physician-Guided Care Coordination" approach to care. Aetna will reimburse the PCP for taking time to make sure that all of the patient’s caregivers are aware of and following the treatment plan prescribed by that PCP; and
*" Provide physicians with detailed clinical data provided by Aetna Health Analytics and through its subsidiary ActiveHealth Management, to identify changes that may be needed and to help assure that the patients receive the right care at the right time and place.

The Patient-Centered Medical Home concept of care has been under development since the mid-90s and is based on a patient having an ongoing relationship with a personal physician trained to provide first contact and continuous, comprehensive care. This personal physician leads a team of care providers at the practice level who collectively take responsibility for the ongoing care of patients, looking beyond the walls of their own office, and communicating with the patient’s other providers to assure the treatment plans are followed. The concept is designed to nurture and strengthen the relationship between the patient and physician.

“PIC sees its role as a physician organization as finding ways to support the practicing physicians in their effort to improve the overall quality of care provided to their patients, and by rewarding physicians for achieving national certification standards. This joint effort will have a significant impact,” said Kevin O’Brien, President & CEO, Partners In Care.

The new model with PIC is another step in Aetna’s efforts to encourage the development and the study of the effect patient-centered primary care models can have on the delivery of health care in America. In October 2007, Aetna announced its support for the Patient-Centered Primary Care Collaborative (PCPCC) which is implementing pilots of a primary-care-based health care model. The collaborative includes the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Osteopathic Association, health benefits companies, as well as major national employers and their associations, quality advocacy groups, academic centers, and consumer advocacy groups.


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