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Aetna to expand accountable care organization strategy Posted: December 29th, 2010

By Maryalene LaPonsie

As health insurance companies search for ways to reduce costs while maintaining patient care, Aetna has been testing the accountable care organization (ACO) model. After a three-year trial, the insurer deemed the test a success and plans to expand its use.

An ACO uses a central case manager to coordinate services. In the Aetna trial of 20,000 Medicare Advantage patients, nurse case managers worked with physicians in 36 primary care practices to reduce unnecessary and duplicative care. They were also responsible for promoting better health management practices.

Aetna reported that nearly all participating medical offices met performance targets. These targets included patient follow-up visits within 30 days of discharge from the hospital and at least two annual office visits for those with certain chronic illnesses, according to an Aetna press release dated Dec. 20. Participating doctors said the program saved time. The Hartford, Conn.-based insurer is now working to expand the use of the ACO model to include additional physicians groups and Aetna members enrolled in commercial medical plans.