- Aetna is partnering with WellBe Senior Medical, a relative newcomer, to ship main care companies to about 10,000 high-risk seniors of their properties, in response to WellBe CEO Jeff Kang, who can be a doctor.
- This system launched in Atlanta final month and is now accessible for sure seniors within the Chicagoland space. For eligible seniors, this implies entry to at-home care 24 hours, seven days every week, lessening the burden of getting a trip to an appointment or venturing to a medical facility amid the pandemic. Even COVID-19 testing could be achieved of their properties.
- Aetna assigns eligible high-risk sufferers to WellBe, which is then chargeable for managing their care and receives capitated funds from Aetna. These eligible are usually seniors of their 80s with a number of power circumstances, together with diabetes, coronary heart failure, osteoarthritis and dementia, Kang stated in an interview with Healthcare Dive.
The coronavirus pandemic has propelled suppliers and insurers to re-examine the way in which care is delivered and reimbursed throughout the nation.
Telehealth and delivering at-home care fashions are hardly new, however the public well being disaster has sped up these traits.
WellBe Senior Medical launched simply final yr, Kang stated, and the pandemic helped expedite conversations with well being plans.
“When the pandemic hit in March, the conversations dramatically accelerated to the purpose the place we stood up and supplied the companies in Atlanta in July after which Chicago in August,” Kang stated of its talks with Aetna. WellBe can be in conversations with different well being plans.
For Aetna, it means tightly managing a gaggle of sufferers which might be more likely to be extra expensive — seniors with a number of complicated well being circumstances. By bringing lower-priced companies to their residence, it additionally retains sufferers out of higher-cost settings like a hospital.
“With every little thing occurring on the planet, giving our members the choice to remain residence and keep social distancing can present peace of thoughts and a brand new approach to expertise healthcare,” Gregg Kimmer, chief Medicare officer of the Nice Lakes marketplace for Aetna, stated in an announcement.
Aetna, which is owned by CVS Well being, covers about 2.7 million Medicare Benefit members and 954,000 Medicare complement members as of June 30, according to its latest 10-Q filing with the U.S. Securities and Trade Fee.
Extra lately, Aetna has partnered with Cleveland Clinic to launch an accountable care group and co-branded insurance coverage plan for employers in northeast Ohio. The deal will enable members nationwide to make the most of digital second opinion companies from Cleveland Clinic suppliers and a Cardiac Middle of Excellence program.
In the meantime, CVS Well being’s profit has soared through the pandemic as medical utilization has flatlined and payers like Aetna are paying much less for medical care as care has been delayed resulting from both stay-at-home orders or considerations about publicity to the novel coronavirus. Having Aetna underneath its umbrella has helped offset the downturn in foot visitors in CVS shops amid this pandemic.