Aetna and Cleveland Clinic introduced an innovative offering for Northeast Ohio firms in August 2020. With a focus on value-based care, the two largest healthcare organizations teamed up to form an accountable care organization (ACO) and offer a co-branded commercial health insurance plan.
- Network services: Wesley Wolfe, executive director of market and network services at Cleveland Clinic, and Angie Meoli, senior vice president of network strategy and provider experience at Aetna, discuss their value-based partnership’s successes and the ACO’s and health plan’s future.
- Launch: “First and foremost, when we started down this journey and vision, neither of us thought we would be launching it during a pandemic,” Meoli recently told RevCycleIntelligence. “It’s one of the first product launches we’ve ever done in the middle of a global pandemic.”
- Progress: Despite the circumstances, Aetna and Cleveland Clinic have “made reasonable progress” on the uptake of the plan. And that is thanks to the plan’s value proposition. “Employers have a tremendous responsibility in making benefits decisions for their employees and those dependent on opts,” explained Wolfe.
- Benefit decisions: Employers currently spend over 250 percent more for healthcare services than Medicare, with some paying up to 300 percent more. These benefit decisions must not only match employee demand for services (e.g., preventative care, mental health care, and access to established physicians), but they must also be cost-effective.
- Accomplishment: “We sat down early on to think through what it is that we’re trying to accomplish and who the stakeholders are,” Wolfe said. We started with patients at Cleveland Clinic because ‘patients first’ is our mantra. But in this instance, it’s the employers who are the purchasers. We have to be able to move into that space and work through what value means for each of the stakeholder groups.”