Twenty years after the regional health care provider group and insurer parted ways, AtlantiCare has announced it will join Aetna's southern New Jersey network of 22 hospitals and more than 5,700 primary care physicians and specialists.
Michael S. Costa, vice president of network operations for Aetna's New Jersey market, said the relationship provides the insurer's 370,000 members in South Jersey with direct access to AtlantiCare's two hospitals in Atlantic City and Pomona and 70 medical facilities, while Aetna looks to attract employers and potential members in the region to its insurance products.
"We've always been interested in a relationship with AtlantiCare because they're an integrated system of highly specialized services that's focused on quality care not only in helping sick members get well, but in staying engaged with patients and keeping them healthy," Costa said. "That helps our goals in figuring out, 'How do we keep our members healthy?'"
As Aetna still plans to launch an accountable-care organization with Hunterdon Healthcare Partners this summer, Costa said the AtlantiCare Health Solutions ACO's acceptance into the Medicare shared savings program last week opens an opportunity for enhanced collaboration in the future.
"While our payment model is fairly standard, I think this contract allows us to build off of a very good base some of the ideas and tenants of health care reform so we can get there in the near term," Costa said. "This is an important first step toward a strong relationship between Aetna and AtlantiCare, characterized by innovation, quality care and affordability for our members."
Though the health care system and insurer broke a network contract 20 years ago, Aetna spokeswoman Susan Millerick said, "this relationship is dramatically different from the relationships we had back then."
"With the focus now on the delivery of patient care, now we think about, 'What can we put on the table beyond being a payer of claims?' " Millerick said. "This new contract is the direction in which contracting is going right now."
AtlantiCare Senior Vice President Lori Herndon said in a statement the organization is "excited to offer all of our quality services to the people we serve in the greater regional service area through the Aetna network," though she did not specify how many new patients the health care system expects to gain from the relationship.