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Aetna teams up with three North Jersey health systems to offer no-premium Medicare plan

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Aetna is launching a new Medicare Advantage plan in October in northern New Jersey that won't charge premiums to Medicare enrollees, who will receive their medical care from a network of three major northern New Jersey health systems and their affiliated physicians and other health care providers.

The health systems — Atlantic Health System, Hackensack University Health Network and Hunterdon Healthcare — as well as the providers affiliated with each of them, will coordinate with one another to provide care to New Jersey Medicare beneficiaries. The plan is called the Aetna Medicare NNJ Prime Plan.

“When we set out to build this plan, we wanted to offer care from some of the most well-known names in acute and ambulatory care in northern New Jersey, and we are pleased to be able to offer a plan and network based on some of the best in the nation,” said John Lawrence, Aetna president, New Jersey. “These highly regarded hospital systems and doctors will work closely with us to help provide each member with a top quality, personalized health care experience, without having to pay a monthly plan premium, which is an incredible value. We are proud to lead the way in New Jersey and nationally with this innovative offering.”

“The NNJ Prime Plan’s focus on quality mirrors many of the initiatives implemented by Atlantic Health to provide the highest level of patient care while also reducing costs and readmissions,” said Joseph A. Trunfio, chief executive of Atlantic Health. “By collaborating with all three health systems, Aetna is ensuring that Medicare members throughout the region have access to this shared approach to quality.”

“All hospitals help people who require medical care, but we recognize the importance of keeping people healthy,” said Robert C. Garrett, chief executive of the Hackensack UHN. “That’s why we are eager to join with programs like Aetna’s Medicare NNJ Prime Plan that place new incentives on long-term health and wellness.”

“Being selected by Aetna to participate in the Aetna Medicare Prime Plan, along with two nationally recognized health care organizations, demonstrates the outstanding medical care available within the Hunterdon Healthcare System,” said Robert P. Wise, chief executive of Hunterdon Healthcare.

Aetna said the NNJ Prime Plan will be an intensive collaboration model involving Aetna nurse case managers who will work within the hospitals and physician practices to assist in complex disease management of the Medicare members. The plan will allow Aetna and the three health systems to share information and resources to improve care and direct outreach to patients.

Aetna said data have shown that collaborations between health care payers, like Aetna, and doctors and hospitals, have a positive impact on quality and cost. Aetna cited a study published in Health Affairs in 2012, which found that an Aetna Medicare provider collaboration program:

  • significantly reduced hospital admissions and readmissions;
  • increased preventive care; and
  • reduced health care costs for the study population compared with unmanaged Medicare.

“The careful tracking of quality metrics is a critical part of why collaborative agreements, such as Medicare provider collaborations and accountable care organizations (ACOs), are successful at improving patient care and are fundamental to the incentive structure,” Lawrence said.  

This plan will be available during Medicare Advantage open enrollment this fall for January 2015 effective dates in Bergen, Essex, Hudson, Hunterdon, Morris, Passaic, Union, Somerset, Sussex and Warren counties.

Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care for all health care consumers. Aetna said its goal is to have 20 percent of its New Jersey membership in value-based collaborative arrangements, including ACOs, by year-end. Nationally, more than 2.3 million Aetna members are served by this health care model.


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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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