Initiatives and studies

Aetna's Provider-Focused Diabetes Pilot

Aetna developed a provider-focused program for African-American and Hispanic diabetic members in a large provider practice in the Dallas area. The program includes the addition of a bilingual diabetic educator and culturally appropriate patient education materials. The success of the pilot will be determined by improving levels of diabetic control and health outcomes of the participants.

Read the press release to learn more about Aetna's pilot with the Medical Clinic of North Texas (MCNT).

The overall goal of the Beginning Right Maternity Program is to decrease the risk of premature delivery. One element of this program focuses African-American women.

This initiative provides at-risk mothers with education and preterm labor identification services early in pregnancy.

Members identifying themselves as African American receive a copy of "Generations - A Pregnancy Guide for Women of African Descent." This educational booklet is published by the Black Infant Mortality Reduction Resource Center, an affiliate of the Northern New Jersey Maternal/Child Health Consortium.

Results showed that African-American women enrolled in the preterm labor program were more likely to have full-term babies than women not enrolled in the program. Since program inception, more than 9,000 African-American women have enrolled in the preterm labor program.

For general information about this program, visit Aetna's Beginning Right® Maternity Program website .

Aetna's Breast Health Disparity initiative reaches out to African-American and Hispanic women age 42 and over who have not had a mammogram according to recommended guidelines from the American Cancer Society. Through letters or outreach calls, we provide culturally sensitive information to address individual risk factors and barriers to obtaining this essential screening. Aetna combines claims data with self-reported race and ethnicity data to identify the members for outreach.

The goals of the initiative are as follows:

• Identify African-American and Hispanic/Latina members who have not had annual screening mammograms
• Identify barriers to screening mammograms
• Provide targeted activities to address identified barriers
• Measure impact of initiative on mammogram rates
• Increase rate of screening mammograms

In 2010, more than 11,000 at-risk women were part of the BHEDI program. For general information on preventing breast cancer, visit Aetna's Women's Health.

Care Considerations are clinical alerts sent to physicians and members based on highly respected sources of evidence-based medicine that identify gaps in care, medical errors and quality issues. Aetna continually evaluates the medical literature to identify care considerations appropriate for targeted populations at risk. Examples of Care Considerations for racial and ethnic minorities include:

• Clinical reminders for sickle cell disease in African Americans
  
• Medication therapy reminder for chronic heart failure in African Americans
  
• Screening reminder for Asian patients with hepatitis B who have a high risk for liver cancer

Aetna offers Cultural Competency Training to health care providers. The training is an online, evidence-based, case-based learning program called "Quality Interactions - a Patient Based Approach to the Cross Culture Care^®."

Goals of this training are:

• To deepen the Aetna clinical community's understanding of disparities among racial and ethnic groups.
  
• To provide ongoing education on cultural competency in health care to improve patient outcomes.

This interactive program focuses on common clinical and cross-cultural scenarios that build a framework of knowledge and skills for delivering quality care to diverse patient populations. Physicians and nurses completing the courses can earn continuing medical education (CME) credits and continuing education (CEU) credits accredited by Tufts University School of Medicine.

The Quality Interactions program is mandatory for all Aetna clinicians. It is also available for network providers and non-participating providers who have filed a claim with Aetna at Aetna's Education Site for Health Care Professionals.

Aetna has engaged in a pilot to address ER utilization in members of minority populations with asthma. While complications from asthma can be life threatening, even fatal, we know that proper treatment can decrease or prevent these complications and improve quality of life for members with asthma. In addition, proper treatment decreases the waste that leads to excess health care costs.

This initiative uses a combination of culturally appropriate items, including:

• Home-based environmental assessment
• Member educational materials
• Telephonic nurse outreach
• Physician engagement
  

The pilot's success will be determined by the health outcomes of the patients, including improved medication compliance. The pilot aims to increase the use of patients' asthma controller medications, as well as to increase member visits to their primary care physician and/or asthma specialist. Additionally, the pilot seeks to reduce avoidable asthma-related ER visits and in-patient hospital admissions.

For more information on Aetna's Emergency Room (ER) Utilization Study, read the press release.

Working in collaboration with Morehouse School of Medicine (MSM) and Health & Technology Vector, Inc., and with partial funding from Sanofi-Aventis, Aetna conducted a randomized control study in 2007 that examined the effectiveness of a hypertension disease management program in attaining and maintaining clinically acceptable blood pressure measurements among hypertensive African-American members.

The Culturally Competent Disease Management Program (CCDMP) was effective in increasing the percentage of members with clinically acceptable blood pressure.

The study was published in April 2010 in the peer-reviewed medical journal, Population Health Management. (PDF, 188 KB)