Aetna Genesis Partnership Trailblazes ACO and Medical Home Concepts

A partnership between Genesis HealthCare and Aetna insurance may be setting the model for accountable care organizations in long-term care.

The program is part of a strategy to reduce re-admissions to hospitals, a costly proposition for insurers, long-term care and hospital providers. Aiding this will be expanded discharge planning, enhanced electronic data sharing, rehabilitation services six days a week, round-the-clock admissions and additional physicians and nurse practitioners at 140 Genesis Mid-Atlantic facilities.

A 10% to 20% decrease in hospitalizations is expected over several years along with savings for Aetna of about $2 million annually.

The partnership has the same goals as future accountable care organizations: increase patient safety and outcomes while also decreasing costs, especially for those recuperating from joint replacements or illnesses such as pneumonia.

In a typical scenario, when an Aetna member leaves a Genesis location, a facility employee calls to schedule an appointment with the primary care physician prior to the member's discharge. The member receives a follow-up call and a discharge summary is sent to the physician. So in addition to trailblazing accountable care, they are also leading the way in the implementation of the medical home, the idea that your primary care physician is your point of contact who assures that all of your healthcare needs are coordinated.

This will be an interesting partnership to follow.

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