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Aetna, Lourdes team up for accountable care organization

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Aetna announced Monday that the Lourdes Health System in Camden is its latest New Jersey accountable care organization partnership.

Numerous such partnerships have been launched statewide by regional health care systems and doctors in recent years. They can give providers financial incentives to work collaboratively to improve patient care — and to get away from the traditional “fee-for-service” model that pays for medical care regardless of whether it improves patient health.

The Aetna agreement with LHS Health Network, an affiliate of Lourdes Health System, begins July 1 and will cover 20,000 Aetna members in Camden, Burlington and Gloucester counties. In addition, Aetna and LHS Health Network will begin a new Medicare provider collaboration serving more than 2,000 Aetna Medicare members.

ACOs are alliances of physicians, hospitals and other providers. They are known as “patient-centric” organizations where clinicians assume responsibility for improving the quality of patient care and lowering costs through better coordination and preventive care.

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John Lawrence, president, Aetna – New Jersey, said the company “will work closely with LHS Health Network to find opportunities to share specific, useful health information. In turn, the physicians will use this information to improve care for members, close gaps in care and reduce waste. We are creating a loop of improved information to drive better care. By working together, we can help bring better health, better care and better cost to thousands of Aetna members.”

Aetna said 135,000 of its members in New Jersey now are in various types of “value-based” collaborative arrangements, including ACOs, and its goal is to reach 215,000, or nearly 20 percent of its New Jersey membership, by year-end. Aetna has ACO agreements with Atlantic Health, parent of Morristown and Overlook Medical Centers; the Hunterdon Healthcare System; and Summit-based Optimus Healthcare Partners, a physician-led ACO.
 
Aetna said that, nationally, more than 1.5 million of its members are covered by these new health care models.

LHS Health Network is a group of health care providers who coordinate care and are accountable for cost, quality and patient satisfaction for the health care they provide, and includes 90 primary care physicians.

“Our new collaboration with Aetna makes sense, given Lourdes’ position in the southern New Jersey market as a high-value provider offering members quality health care services in the most efficient manner,” said Alexander J. Hatala,  chief executive of Lourdes Health System and the LHS Health Network.
 
Under the agreement with LHS, Aetna also is implementing a Medicare Provider Collaboration model to improve care to more than 2,000 Aetna Medicare Advantage members, who may have complex health care needs.

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Beth Fitzgerald

Beth Fitzgerald

Beth Fitzgerald reports on health care, small business and higher education. She joined NJBIZ in 2008 after a 34-year career at the Star-Ledger and has been reporting on business in New Jersey since 1978. Her email is beth@njbiz.com and she is @bethfitzgerald8 on Twitter.

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