National insurer Aetna and Sutter Health, a 24-hospital not-for-profit system in Sacramento, Calif., have struck an agreement to initiate a health plan developed to lower healthcare costs for employers and their workers.
Starting mid-2018, Sutter and Hartford, Conn.-based Aetna plan to sell coverage to self-insured employers in greater Sacramento of California, Central Valley and Bay Area communities. The companies will later give preferred provider organization policies to completely insured employers in the year of early 2019.
Aetna insures over 415,000 individuals in northern California.
The 50-50 joint venture, in which Sutter Health and Aetna would concentrate on using data analytics to recognize at-risk patients to treat them sooner, is Aetna’s fifth. An Aetna spokeswoman refused to release any financial terms of the deal.
The insurer has formed similar joint health plans with Allina Health, Texas Health Resources, Banner Health, and Inova Health System.
Insurer-provider partnerships are becoming more usual as health plans and systems grapple with how to lower charges and make better the outcomes of the patients they serve.
In such partnerships, health plans provide incentives to drive patients to the health system’s narrow network of providers with the promise of higher quality and lower costs. Sufferers who select to seek care outside of the network may pay most or all of the cost of care out of pocket.
Aetna said 45 percent of its payments are tied to value-based care contracts, and it hopes to bump that up to 75 percent by the year of 2020.
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