"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:
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.
About Partners In Care, Corp.
Physician owned and governed, Partners In Care is a physician organization dedicated to 21st century health care delivery and financing. Partners In Care has been successfully operating performance-based incentive programs involving approximately 80,000 members over the past ten years. PIC currently provides health plan improvement services to a number of health plans and employer/plan sponsors. The clinical/financial reporting capability allows PIC to deliver actionable information to physicians who participate in our various programs. www.piccorp.com
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 37.2 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. www.aetna.com.