Aetna Inc. was created in 1853, and over that period has become a pillar in America for managing health care supplying its expertise in the field. For over 160 years, Aetna has provided health care and life insurance services to Americans and citizens worldwide. Through the Aetna Way, the company has achieved “health and financial security by providing easy access to safe, cost-effective, high-quality health care and protecting their finances against health-related risks” (Aetna, 2017). Aetna delivers integrity, excellence, care, and inspiration for approximately 46.7 million people in need of medical help. (Aetna, 2017). These core values are what has driven the company to make everyday decisions that can better serve and protect their members.
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In fact, Aetna has begun taking steps to help improve the quality of care that they offer their patients through new value-based payment models for health care providers. In 2015, Aetna introduced a new insurance scheme that featured “new payment agreements to reward providers for meeting quality, efficiency and patient satisfaction measures” (GBN, 2014). Also, Aetna and Sharp Community Medical Group (SCMG) are bringing about change in the San Diego to distribute a “more coordinated and personalized medical care” to all Aetna affiliates within that market (Business Wire, 2011). Just like Washington, the goal is to enhance the medical experience and outcomes of patients by implementing a reimbursement program that compensates SCMG physicians for satisfying Aetna patients and improving their quality of health as …show more content…
In doing so, there has been a vast improvement in the quality of care for these patients, while also a lowered health care cost for them as well. Through the Provider Collaboration program, the nurse case managers could aid in the improving certain clinical quality metrics. Such improvements include the percentage of doctor visits per calendar year by Aetna Medicare Advantage members, annual blood glucose testing for those with diabetes, and semi-annual doctor visits by those suffering from chronic heart failure, chronic obstructive pulmonary disease, and diabetes (Business Wire,
In fact, Aetna has begun taking steps to help improve the quality of care that they offer their patients through new value-based payment models for health care providers. In 2015, Aetna introduced a new insurance scheme that featured “new payment agreements to reward providers for meeting quality, efficiency and patient satisfaction measures” (GBN, 2014). Also, Aetna and Sharp Community Medical Group (SCMG) are bringing about change in the San Diego to distribute a “more coordinated and personalized medical care” to all Aetna affiliates within that market (Business Wire, 2011). Just like Washington, the goal is to enhance the medical experience and outcomes of patients by implementing a reimbursement program that compensates SCMG physicians for satisfying Aetna patients and improving their quality of health as …show more content…
In doing so, there has been a vast improvement in the quality of care for these patients, while also a lowered health care cost for them as well. Through the Provider Collaboration program, the nurse case managers could aid in the improving certain clinical quality metrics. Such improvements include the percentage of doctor visits per calendar year by Aetna Medicare Advantage members, annual blood glucose testing for those with diabetes, and semi-annual doctor visits by those suffering from chronic heart failure, chronic obstructive pulmonary disease, and diabetes (Business Wire,