October 2014, Parsippany, NJ – Aetna (NYSE: AET) today announced a new Medicare Advantage plan that will be available this October in 10 counties in Northern New Jersey. The Aetna Medicare NNJ Prime Plan is a Medicare Advantage HMO based on a network of three Northern New Jersey health systems and their affiliated physicians and other health care providers.
The health systems – Atlantic Health System, Hackensack University Health Network (HackensackUHN) and Hunterdon Healthcare – as well as the providers affiliated with each of them, will coordinate to provide high quality, efficient, convenient and affordable care to New Jersey Medicare beneficiaries.
“When we set out to build this plan, we wanted to offer care from some of the most well-known names in acute and ambulatory care in Northern New Jersey, and we are pleased to be able to offer a plan and network based on some of the best in the nation,” said John Lawrence, Aetna president, New Jersey. “These highly regarded hospital systems and doctors will work closely with us to help provide each member with a top quality, personalized health care experience, without having to pay a monthly plan premium, which is an incredible value. We are proud to lead the way in New Jersey and nationally with this innovative offering.”
“The NNJ Prime Plan’s focus on quality mirrors many of the initiatives implemented by Atlantic Health System to provide the highest level of patient care while also reducing costs and readmissions,” said Joseph A. Trunfio, president and CEO of Atlantic Health System. “By collaborating with all three health systems, Aetna is ensuring that Medicare members throughout the region have access to this shared approach to quality.”
“All hospitals help people who require medical care, but at HackensackUHN we recognize the importance of keeping people healthy.” said Robert C. Garrett, president and CEO of the HackensackUHN . “That’s why we are eager to join with programs like Aetna’s Medicare NNJ Prime Plan that place new incentives on long-term health and wellness. At HackensackUHN, we have earned national recognition for our experience in coordinated care and now with Aetna we will be able to bring this expertise to an even larger portion of our region.”
“Being selected by Aetna to participate in the Aetna Medicare Prime Plan, along with two nationally recognized health care organizations, demonstrates the outstanding medical care available within the Hunterdon Healthcare System,” stated Robert P. Wise, President and CEO, Hunterdon Healthcare. Many Medicare members have complex health care needs that go undetected. The Aetna Medicare NNJ Prime Plan is an intensive collaboration model involving Aetna nurse case managers who will work within the hospitals and larger physician practices to assist in complex disease management of Aetna’s NNJ Prime Plan members alongside their primary care physician. The plan will allow Aetna and the participating health systems to act on shared information and resources in a manner that is designed to help improve care and direct outreach. Similar to other Medicare collaborations in place in New Jersey and elsewhere, Aetna nurse case managers will work closely with physicians to identify and coordinate care and help increase adherence to best practices and treatment plans.
In a study published in Health Affairs in 2012, an Aetna Medicare provider collaboration program:
- Significantly reduced hospital admissions and readmissions;
- Increased preventive care; and
- Reduced health care costs for the study population compared to unmanaged Medicare.
“The careful tracking of quality metrics is a critical part of why collaborative agreements, such as Medicare provider collaborations and accountable care organizations (ACOs), are successful at improving patient care and are fundamental to the incentive structure,” said Lawrence. The Aetna Medicare NNJ Prime Plan takes Aetna’s Medicare Collaboration model to the next level by completely aligning incentives across Aetna and the participating health systems.The metrics to be tracked include:
- The percentage of members receiving recommended preventive care and screenings;
- Management of patients with chronic conditions, such as diabetes and heart failure;
- Reductions in avoidable hospital readmission rates; and
- Reductions in unnecessary emergency room visits.
This plan will be available during Medicare Advantage open enrollment this fall for January 2015 effective dates in Bergen, Essex, Hudson, Hunterdon, Morris, Passaic, Union, Somerset, Sussex and Warren counties. Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care for all health care consumers. Aetna’s goal is to serve 20 percent of its New Jersey membership through value-based collaborative arrangements, including ACOs, by year-end. Nationally, more than 2.3 million Aetna members are served by this health care model. Learn more about Aetna Medicare Prime HMO or call 1-888-247-1028.
Aetna is one of the nation's leading diversified health care benefits companies, serving an estimated 45 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. Learn more about Aetna >