Aetna and CHI Health Create Nebraska’s First Commercial Accountable Care Organization

Article Date: Apr 29, 2015 Media Contact:

OMAHA, Neb. (April 29, 2015) – Aetna (NYSE: AET) and CHI Health today announced Nebraska’s first commercial, product-based accountable care organization (ACO) that will offer Omaha employers a health care model designed to improve quality, outcomes, efficiency and the patient experience. The health care savings will be specific to each employer, with the potential to save up to 15 percent over comparable Aetna full network products.

The new commercial health care product, known as Aetna Whole HealthSM – CHI Health Accountable Care Network, will provide Aetna members with highly coordinated care through UniNet, CHI Health’s clinically integrated network. The overall network contains approximately 500 primary care physicians, 2,000 specialists and 13 hospitals in the Aetna Whole Health - CHI Health Network. The new ACO further builds on Aetna and CHI’s growing relationship.

The value-based patient-centric model of health care focuses on keeping people healthy rather than just treating them when they are sick.

Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. Nationally today, about 3.2 million Aetna members receive care from doctors committed to the value-based approach, with 30 percent of Aetna claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 50 percent by 2018 and 75 percent by 2020.

In Nebraska, Aetna has 16 percent of its members served through value-based collaborative arrangements with the intent to reach over 25 percent of its members in 2015. Aetna has more value-based networks in Nebraska than any other carrier.

“CHI Health and Aetna are helping to shift the health care system from one that focused on quantity of services to one that focuses on quality of care,” said Dale Mackel, president of Aetna’s Nebraska and Iowa operations. “The outcome is a healthier community, more affordable costs and fewer people in hospitals.”

Aetna Whole HealthSM – CHI Health Accountable Care Network plans are designed to give Nebraska businesses in Burt, Cass, Dodge, Douglas, Otoe, Sarpy, Saunders and Washington counties better health care options for their employees. The network is planned to expand to other Iowa and Nebraska counties in the near future.

The plans feature a new model of health care delivery designed to offer:

  • More coordinated, team-based care among doctors and other care providers;

  • Enhanced patient experience through best-in-class care management programs and technology that delivers information to all providers;

  • Lower overall out-of-pocket costs for members who see providers that are part of the Aetna Whole HealthSM – CHI Health Accountable Care Network; and

  • Better health care outcomes.

Aetna Whole HealthSM – CHI Health Accountable Care Network will be available in the Omaha metropolitan area to self-insured businesses beginning June 1 for an effective date of July 1. Fully insured plans in Iowa and Nebraska and self-insured plans in Iowa will be offered in 2016.

“CHI Health has made a Three-Part Commitment to Nebraska to promote cost transparency, accountability and make great health care more affordable,” said Cliff Robertson, MD, CEO of CHI Health. “This relationship with Aetna makes the affordability component of our commitment real by rewarding providers for delivering excellent primary care, preventive screenings and better care for chronic conditions.”

New payment agreement to reward improvements in quality and cost of care The agreement rewards Aetna Whole HealthSM – CHI Health Accountable Care Network physicians for meeting quality and efficiency measures, including:

  • The percentage of members who get recommended preventive care and screenings;

  • Better management of patients with chronic conditions such as diabetes and heart failure; and

  • Decreasing avoidable emergency room visits and hospital readmissions through the proactive management by care teams.

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.

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About CHI Health

CHI Health is a regional health network with a unified mission: nurturing the healing ministry of the Church while creating healthier communities. Headquartered in Omaha, the combined organization consists of 15 hospitals, two stand-alone behavioral health facilities and more than 150 employed physician practice locations in Nebraska and southwestern Iowa. More than 12,000 employees comprise the workforce of this network that includes 2,820 licensed beds and serves as the primary teaching partner of Creighton University’s health sciences schools. In fiscal year 2014, the organization provided a combined $149.3 million in quantified community benefit including services for the poor, free clinics, education and research. With locations stretching from Kearney, Neb. to Missouri Valley, Iowa, the health network is the largest in Nebraska and serves residents of Nebraska and southwest Iowa. For more information, visit online at CHIhealth.com

About UniNet

UniNet is a local, physician-driven, clinically integrated network bringing together providers from across the state of Nebraska and western Iowa who are dedicated to improving the health and wellbeing of the communities we serve. UniNet has been in the Omaha area since 1998 and currently represents more than 2,200 independent and employed providers, 30 hospitals, and affiliated ancillaries and skilled nursing facilities. UniNet builds on the successes and strengths of CHI Health and affiliated providers to improve patient health, enhance efficiency and succeed in today’s changing health care payment and delivery environments.

About Aetna

Aetna is one of the nation's leading diversified health care benefits companies, serving an estimated 46 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, workers' compensation administrative services and health information technology products and services. Aetna's 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 and learn about how Aetna is helping to build a healthier world. @aetnanews


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