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April 2, 2014

Aetna, Middletown doc group sign ACO-like agreement

Photo | CNN

Hartford health insurer Aetna and an independent group of Connecticut physicians said they’ve added new contract terms that will reward providers for meeting certain performance metrics related to health outcomes, costs and patient satisfaction.

Under the so-called value-based collaborative care agreement with Middletown-based Medical Professional Services Inc., doctors will be evaluated based on their ability to reduce pharmacy costs, hospital readmissions and avoidable emergency room visits, Aetna said.

The insurer will also help defray MPS’ personnel and health IT costs related to care coordination.

MPS has more than 400 doctors across the state.

The contract is a bit different from an accountable care organization (ACO) contract, according to David Finn, Aetna’s executive director for networks.

Both models provide financial incentives to providers based on population-based health, but ACOs typically include broader provider groups and hospitals.

Other insurers are certainly eyeing similar models.

Bloomfield health insurer Cigna said Wednesday it has begun targeting smaller physician and specialist groups with a new suite of “collaborative care plans,” which are based on its ACO-like arrangements with larger provider groups.

Cigna did not announce any specific Connecticut contracts, but said it has pilot arrangements with small physician groups in select markets.

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