Aetna and Rush Health Create First-of-Its-Kind Accountable Care Organization in Illinois

Members Benefit from Greater Choice and an Improved Patient Experience

CHICAGO – Aetna (NYSE:AET) and Rush Health today announced a collaboration to launch Aetna Whole Health Chicago, a first-of-its-kind commercial health care product in Illinois that provides members with access to highly coordinated care that tracks outcomes, shares data and measures clinical standards to improve quality and efficiency.

Aetna Whole Health Chicago enables a greater choice of products for employees of Illinois businesses. The arrangement is the first accountable care organization (ACO) in Illinois that allows members to choose being a part of an ACO rather than being moved into it.

"We are shifting the health care system from one that focuses on quantity of services to one that offers consumers more choice, more value from services, and higher quality care at a more affordable price," said Nitin Bhargava, president of Aetna's Illinois operations. "The outcome can be a better patient experience, a healthier community and fewer people in hospitals."

As part of Aetna Whole Health Chicago, Aetna members will receive highly coordinated care through Rush Health's 1,300 primary care physicians and specialists across its four hospitals.

"The Aetna Whole Health Chicago product is completely aligned with the mission and values of our organization and providers, and is unique compared to other local health plan choices," said Brent J. Estes, president and chief executive officer of Rush Health. "Employers and consumers will have access to a high-value product comprised of premier providers focused on improving quality and access, and reducing costs."

Aetna Whole Health Chicago will be available to self-insured businesses beginning November 1 for an effective date of March 1, 2016. Fully insured plans will be available November 1 for an effective date of April 1, 2016. For 2017, it is anticipated that the Rush Health arrangement also will be available to individuals via the health insurance Marketplace.

Aetna Whole Health Chicago plans are designed to give greater choice and better health care options to fully insured and self-insured members in Cook, DuPage, Kane, Lake, Kendall, Will, Kankakee and McHenry counties. Members could see:

  • Coordinated, team-based care among doctors and other care providers;
  • Enhanced patient experience through high quality care management programs and technology that delivers information to all providers;
  • Lower overall out-of-pocket costs for members who see providers that are part of Aetna Whole Health Chicago; and
  • Better health care outcomes.

New payment agreement to reward improvements in quality and cost of care

The agreement rewards Rush Health physicians for meeting quality and efficiency measures, including:

  • The percentage of Aetna members who get recommended preventive care and screenings;
  • Better management of patients with chronic conditions such as diabetes and heart failure; and
  • Decreasing avoidable emergency room visits and hospital readmissions through the proactive management by care teams.

Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. Nationally today, about 3.2 million Aetna members receive care from doctors committed to the value-based approach, with 30 percent of Aetna claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 50 percent by 2018 and 75 percent by 2020.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.7 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see

About Rush Health

Rush Health is a collaborative, member-based network of Chicago-area physicians and hospitals, working together to improve health through high quality, efficient health services covering the spectrum of patient care from wellness, prevention and health promotion, to complex care management. Rush Health is comprised of more than 1,300 providers practicing at Riverside Medical Center, Rush-Copley Medical Center, Rush Oak Park Hospital and Rush University Medical Center.

Aetna Media Contact:

Rohan Hutchings

Rush Health Media Contact:

John Pontarelli