The Children's Hospital of Philadelphia has sealed an accountable care organization deal with Aetna to offer coordinated care to pediatric patients in Burlington County, N.J., and the five counties in the Philadelphia area. The deal, which is Aetna's first pediatric ACO, supports the insurer's efforts to transition to a value-based payment model.
Aetna has sealed accountable care organization agreements with Quality Health Alliance and Mercy Accountable Care. The ACOs are expected to offer coordinated care to cut out-of-pocket costs and boost quality of care for patients in southeastern Pennsylvania.
Aetna's offer to buy Humana would expand Aetna's product portfolio from primarily commercial insurance plans to include Medicare managed care plans. Medicare and Medicaid are expected to grow, driven by the Affordable Care Act and a surge in retiring baby boomers.
Aetna said it will acquire its smaller competitor Humana for $37 billion in cash and stock, the insurance industry's biggest deal ever. The acquisition would almost triple Aetna's Medicare Advantage business. Many health care mergers and acquisitions have been delayed as the industry awaited last week's Supreme Court ruling on the U.S. health care law, analysts said.
Aetna and Catholic Health Initiatives unit CHI Health will offer an accountable care coverage option to employers in the Omaha, Neb., area. The new Aetna Whole Health–CHI Health Accountable Care Network could save employers up to 15% compared with Aetna's traditional plans. The network will include 13 hospitals, 500 primary care physicians and 2,000 specialists.