Cleveland Clinic and Aetna, a CVS Health Company (NYSE: CVS), are collaborating to offer new plans that aim to reduce health care costs for participating employers and expand Aetna members’ access to Clinic providers.
Their collaboration includes launching a co-branded insurance plan, an expanded relationship nationwide, the formation of an Accountable Care Organization (ACO) model and the deployment of Cleveland Clinic’s Cardiac Center of Excellence program to Aetna plan sponsors, according to a news release.
“Given the current economic climate, employers are looking for a cost-effective, high quality insurance plan that also provides access for their employees to coordinated care and advanced medical expertise,” said Steven C. Glass, the Clinic’s chief financial officer, in a provided statement. “Cleveland Clinic is committed to improving the health and wellbeing of Aetna members, and we look forward to working together to deliver value-based health care to an expanded patient population.”
In 2017, the Clinic announced a co-branded insurance plan with Oscar Health, the health system’s first heavy play in the insurance business. The plan quickly exceeded initial expectations.
The Aetna Whole Health – Cleveland Clinic co-branded commercial plan aims to provide positive clinical outcomes, improved experience and reduced total cost of care to Northeast Ohio employers and their plan members, according to the release, which notes care will be delivered and coordinated through the Clinic’s network of employed, aligned and affiliated providers.
The plan is designed to be a cost-effective offering beyond Aetna’s typical broad network plans. Cleveland Clinic and Aetna estimate that participating employers could save as much as 10% in health care spending with the new plan compared to a current Aetna broad network plan, according to the release.
Fully insured and self-insured employers in Ashtabula, Cuyahoga, Geauga, Lake, Lorain, Medina, Portage, Stark, Summit and Tuscarawas counties will be able to purchase the co-branded plan this fall, depending on segment and group size.
Under the new plan, Aetna members can receive care from the Cleveland Clinic Quality Alliance network of employed and independent community physicians or at any facility of the Clinic, which will be rewarded for achieving quality and cost targets, according to the release.
Through an expanded relationship nationwide, members enrolled in Aetna commercial plans can access second opinions by the Clinic for certain conditions. A new program offers Aetna commercial members streamlined scheduling for specialty services and access to health-plan directed, virtual second opinions at the Clinic through a dedicated referral line for Aetna members. Aetna care managers will work with members individually to navigate their health needs and personalized care plans.
The organizations are also launching a Cardiac Center of Excellence program to offer Aetna plan sponsors across the country cardiac care at the Clinic. The program is designed to offer patients improved clinical outcomes and faster return to work and other activities, according to the release.
“As part of CVS Health’s goal of becoming the most consumer-centric health company, we are facilitating access to high-quality health care where and when consumers need it,” said Angie Meoli, senior vice president of network strategy and provider experience for Aetna, in a provided statement. “Cleveland Clinic is renowned for delivering exceptional health care, and our new collaboration will enable our members to receive the personalized and coordinated care they need to get and stay healthy.”