Aetna Collaborates with ProHealth Physicians to Achieve Triple Aims for Patient Care

From the primary care physician’s office to specialists and facilities, patients will enjoy a more coordinated health care experience

HARTFORD, Conn.--(BUSINESS WIRE)--Aetna (NYSE: AET) and ProHealth Physicians, Inc. (ProHealth) today announced details of a new accountable care collaboration in Connecticut that will support Medicare and privately insured patients. The collaboration with ProHealth is powered by the Healthagen integrated suite of technology and services. Healthagen is a division of Aetna that offers population health management solutions and health information technologies. ProHealth is one of the largest primary care systems in the Northeast, caring for more than 350,000 active patients in Connecticut.

“Working together, Healthagen and ProHealth are bringing the future of health care into reality today. We are forging new ground characterized by innovation and collaboration”

Coordinating Care for Medicare Patients

The collaboration will support ProHealth’s participation in the Medicare Shared Savings Program (MSSP) and ProHealth’s agreements with its commercial managed care partners and plan sponsors. Together, Aetna and ProHealth will enhance the coordination of care for ProHealth’s 30,000 Medicare patients throughout Connecticut.

Patients who need care and support for emerging and chronic health issues will be identified through proactive collaborative care management and sophisticated analytics provided by Healthagen. By identifying the patients who may benefit, the appropriate clinical programs and health interventions can be delivered to them. Together, care management technology, care managers, clinical staff and providers will form a care team to help prevent avoidable health issues, effectively manage those that exist and minimize the progression of chronic disease. The combined collaboration will have a significant focus on patient engagement and compliance to help ensure the long-term success of the overall effort.

The new accountable care agreement is designed to improve the quality of care for ProHealth’s patients while lowering overall health care costs. Over the next twelve months, ProHealth will apply Healthagen’s payer-neutral population management and integrated solutions among its broader patient population, including Aetna fully insured commercial members and Medicare Advantage members who receive their care from ProHealth.

“Working together, Healthagen and ProHealth are bringing the future of health care into reality today. We are forging new ground characterized by innovation and collaboration,” said Martha Temple, president of Aetna’s New England health plan operations. “Healthagen’s integrated technology will provide ProHealth’s physicians with greater access to the broad spectrum of information they need to more effectively manage patient care and make the patient experience simpler and more effective.”

Focus on Quality

C. Todd Staub, MD, chairman of ProHealth, stated, “ProHealth is committed to achieving the triple aims of improved patient outcomes, increased patient satisfaction and improved cost-effectiveness. We look forward to collaborating with Aetna in support of these efforts.”

Jack Reed, president and CEO of ProHealth, stated that this relationship will align the process improvements that the health care system requires to ensure that patients and their families are better able to manage the value and cost of health care services.

Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care. Aetna’s solutions help all types of patients, regardless of payer. Information about Accountable Care Solutions from Aetna is available at www.aetnaacs.com.

About ProHealth Physicians

ProHealth is the state’s largest physician-owned delivery system and has a successful history of meeting key clinical and cost performance targets for plan sponsors and payers. As of January, 2013, ProHealth was awarded a MSSP designation by Medicare allowing ProHealth to participate in the Medicare Shared Savings Program. ProHealth is based in Farmington, Connecticut and has 80 locations within the State. Formed in 1997, ProHealth has grown to include more than 300 primary care providers and offers select specialty and diagnostic/therapeutic services such as ENT, pediatric and adult gastroenterology, plastic surgery, imaging, physical therapy, sleep medicine centers, ADHD expertise, a hearing center, and six extended-hours locations to meet patients’ needs for access and convenience. Since 2003, ProHealth’s clinical performance program has enabled its providers to identify patients who are due for specific healthcare screenings and tests based on the clinical guidelines relevant to the individual patient’s condition. ProHealth currently serves about 10% of Connecticut’s population and is expanding throughout the State.

About Healthagen

Healthagen is a division of Aetna that offers health and technology services to providers, payers, employers and consumers. Healthagen brings together a wide range of payer-neutral population health management solutions and health information technology capabilities from its businesses that include ActiveHealth Management, Medicity and iTriage. Our solutions are designed to improve care quality, control health care costs and engage consumers in their health care. Learn more at www.healthagen.com.

About Aetna

Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 37.3 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 and health information technology services. Our 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. For more information, see www.aetna.com.