Providing Discounted Care to Special Olympics Athletes at MinuteClinic

Bottom of the article

Athletes, perhaps more than anyone else, understand the importance of being on top of their physical health.

To make it easier for some of our country’s most impressive athletes to access lower cost, high-quality care, MinuteClinic is working with Special Olympics to provide sports physicals at a discounted rate.

From now through July 31, 2020, Special Olympics athletes will be able to present a voucher at any MinuteClinic location in CVS Pharmacy or Target and receive a sport physical at the discounted rate of $49, no appointment necessary.Local state organizations may have alternate arrangements.

This promotion provides all Special Olympics athletes with access to this necessary care regardless of their insurance status or whether they have a primary care provider.

Easy-to-Access, Lower-Cost Care

Athletes aren’t the only ones who benefit from the type of proactive care that MinuteClinic offers. With 1,100 locations in 33 states and Washington, D.C., patients have access to a wide range of services at MinuteClinic, including wellness screenings, vaccinations, and chronic condition monitoring.

And when a minor illness or injury does arise, MinuteClinic’s nurse practitioners and physician assistants can often provide care for those conditions as well, including earaches, sprains, skin conditions such as rashes or poison ivy, sore throats and infections of the respiratory system or urinary tract.

At CVS Health, we’re committed to ensuring that patients have access to the quality, affordable care that will keep them in their best health and at the top of their game.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
0
Display Hero
Off

Meeting Women’s Health Care Needs

Bottom of the article

CVS Health works vigorously to expand access to high-quality, convenient and affordable women’s health care services through our MinuteClinic, retail pharmacies in communities nationwide and online or in the palm of their hand. As part of our focus on transforming the consumer health care experience, we are committed to providing women with access to the coordinated services and care they need to manage conditions and determine what is best for their health.

Providing Convenient Access to High-Quality Women’s Care

Women, who are often key in maintaining healthy families, access the health system more frequently than men, both for themselves and on behalf of their children. In turn, this means that their own health care can take a backseat to the needs of others.

Many women may find it difficult to receive care at a convenient time and location. For example, a survey conducted by Morning Consult and sponsored by CVS Health revealed that 90 percent of women consider the convenience of location important when accessing health services, while 85 percent consider flexible and extended hours important when selecting a health care facility.Morning Consult poll conducted from October 25-26, 2018, among a national sample of 2,201 adults

Our more than 1,100 MinuteClinic locations offer a full range of essential women’s health services. These services include access to birth control, the human papillomavirus (HPV) vaccine, treatment for yeast infections and pregnancy, urinary tract and bladder infection testing. Additionally, MinuteClinic providers also help women better understand their reproductive health options and provide referrals to primary care physicians or OB/GYNs, as needed.

CVS Health also launched a MinuteClinic University Health program, aimed at addressing the health care gap when young adults leave home for school. Our MinuteClinic locations in certain geographic areas near universities and campuses offer additional services for sexual health, women’s health and well-being screenings.

Increasing Patient Access to Birth Control

Ensuring accessible and affordable medications, including birth control, is a priority at CVS Health. For example, CVS Pharmacy patients can pick up prescriptions ordered through the CVS app on their phone, online, in person at CVS retail pharmacies, or they can have their medications delivered through our home delivery program. Additionally, CVS Caremark Members can receive their prescriptions through our mail order pharmacy, and throughout our network of 68,000 retail and mail order pharmacies.

We also work with public health advocates across the country to ensure that women can be obtain a birth control prescription from their local pharmacist. Pharmacists are currently allowed to prescribe oral birth control medications through Prescriptive Authority and Collaborative Practice Agreements in 13 states and the District of Columbia – covering 2,464 CVS Pharmacy locations. And we will be able to do so in 14 more states by the end of the year.

Affordable Access in the Community

Through community partnerships and philanthropies, we are able to address some of the health challenges women face locally. The CVS Health Foundation has partnered with a variety of groups who are on the front lines of improving access to women’s health services.

For example, we’ve established a multi-year partnership with the National Association of Free & Charitable Clinics (NAFC) with grants awarded to free and charitable clinics to increase access to care, improve health outcomes and lower overall health care costs. Today, 58 percent of NAFC patients are women – and they rely on 1,400 clinics nationwide for services including breast and cervical cancer screening, maternal and infant health and much more.https://www.nafcclinics.org/sites/default/files/NAFC%202019%20Infographic.pdf Since launching the partnership, the CVS Health Foundation has delivered a total of more than $4.5 million in funding to free and charitable clinics across the country.

Addressing Women’s Heart Health

Cardiovascular disease remains the number one killer among women and accounts for one-third of deaths annually.https://www.heart.org/-/media/data-import/downloadables/heart-disease-and-stroke-statistics-2018---at-a-glance-ucm_498848.pdf To address the widespread impact of this disease, we help women understand their risk for heart disease and empower them to take the next best action for their health. Throughout February 2019, we provided preventive heart health screenings at no cost in which women learned their five key personal health numbers that help determine their risk for heart disease: total cholesterol, HDL (good) cholesterol, blood pressure, blood sugar and body mass index.

Additionally, our support of the American Health Association Go Red for Women campaign, includes a new three-year, $15 million commitment to life-saving cardiovascular research and education.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
4
Display Hero
Off

How One Man Unintentionally Overdosed Every Day on Blood Thinners

Bottom of the article

Half of heart disease patients don’t take their medications as recommended. As a result, they end up in the hospital more often. Yet a recent study of cardiologists found most didn’t know if their patients are taking the medicines they prescribed to help prevent heart problems. Most said they don’t ask if patients are taking their medications, even though the doctors know how important it is.

A new form of health plans, called accountable care organizations (ACOs), are bridging the communication gap between doctors and their patients. ACOs are integrated networks of hospitals, doctor’s offices and other health care facilities that get paid by an insurer based on the quality and efficiency of care their patients receive – not how many visits, tests, surgeries and hospital stays they bill. Working together with the insurer, they can have access to information about an ACO patient’s care.

That means the doctor has more information at his or her fingertips when the patient visits. Has the patient been filling his prescriptions regularly? What were the results of the most recent tests he had? What other doctors have seen him, and what treatment or recommendation came from that visit?

Where it’s working

Leaders from two organizations offering ACOs in cooperation with Aetna talked about the advantages of ACO arrangements at a recent bswift conference.

“Too often doctors don’t know what’s going on with the patient at other doctors or hospitals. The insurer knows,” said Dan Styf, senior vice president at Memorial Hermann Health System and CEO of the Memorial Hermann Health Plan in Houston. “Data from claims gives us perspective, so when the patient is sick and shows up in the system, we can see what is happening and take action.”

Three different doctors unknowingly prescribed blood thinners to the same patient. As a result, the patient was unintentionally overdosing on blood thinners… every day.

At Advocate Physician Partners in Chicago, the patient record system showed a man with a heart condition was already a “frequent flyer” in his local Advocate emergency room. A care manager called the patient to see if she could help.

According to Scott Kent, vice president of Field Operations for Advocate Physician Partners, the care manager found the patient was already being seen by two other doctors outside the ACO. None of them knew about the other doctors, so all three doctors had prescribed blood thinners. The patient’s unintentional daily overdose was sending him to the ER.

ACOs growing across the country

Established with private insurers or as part of a Medicare or Medicaid program, existing ACOs are growing and new ACOs are starting up; they are now in 49 states and the District of Columbia (the only state without one today is North Dakota). The federal government alone has almost 500 ACO arrangements for Medicare and Medicaid recipients, and many private insurers are entering into ACO arrangements at a similar pace. Aetna, for example, is on track to have 75 percent of its payments in value-based care arrangements, including ACOs, by 2020.

Under these value-based arrangements, the health systems are paid based on the quality and efficiency of care their patients receive. Many of the quality measures are related to the effective use of medications. That means ACOs put particular focus on making sure patients are on the right medications and are taking them as directed.

ACOs put particular focus on making sure patients are on the right medications and are taking them as directed.

Some health plans are built around an ACO. For example, Aetna and bswift, the Aetna company that offers private exchange and benefit administration capabilities to employers, brokers and other organizations, offer ACO-based plans to employers and individuals in many areas of the country.

People who belong to other plans and choose a doctor or hospital that is part of an ACO network may also get the benefits of the arrangement, and not even know it. Those benefits include improved quality measures, shorter hospital stays, fewer readmissions and increased use of generic drugs – all of which mean the patient can spend less on health care.

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
0
Display Hero
Off

Navigating a Behavioral Health Issue (Hint: Avoid the Internet)

Bottom of the article

Unlike the flu – which a physician can typically diagnose and prescribe any necessary treatment for in a single office visit – navigating a behavioral health issue such as depression or substance use disorder is less clear.

“Understanding behavioral health conditions, and knowing where and when to seek help, can be a completely new experience for a member,” said Antonio Rocchino, Senior Director, Network Management, Aetna Behavioral Health. “We understand the instinct to try to find a facility on Google or seek help from a doctor featured on the news, but they may not provide the quality or expertise required in the particular situation.”

According to researchAetna Behavioral Health surveyed 273 members of the Building a Healthy Tomorrow and Aetna Medicare Communities from September 14 – 24, 2018. conducted by Aetna Behavioral Health, nearly 50 percent of consumers relied on the internet to identify inpatient behavioral health services. For those seeking an outpatient behavioral health provider, consumers asked their doctor for a referral (29 percent), called their insurance company (26 percent) or utilized a personal recommendation (17 percent).

“When seeking to access behavioral health care, attempting to reconcile a variety of recommendations, and the associated costs, should not be another source of stress,” said Rocchino.

Aetna is ready to help members identify appropriate care in their communities.

Aetna Behavioral Health can help members and their loved ones identify resources that best fits the situation, including facilities that are part of its Institute of Quality® network. These facilities, available in certain states, meet strict criteria and specialize in treating substance use disorder. Aetna Behavioral Health is also collaborating with certain facilities to go a step further and provide a personalized experience for the member, as well as their family and caregivers. Services could include certified peer support specialists and resources to improve social determinants of health, such as financial and legal issues.

Finally, and equally important, going in network may mean less money out of members’ pockets, and more services covered within agreed upon rates with providers.

Ready to learn more about behavioral health and accessing care? Aetna Behavioral Health has produced a series of new Let’s Talk Videos to help members better understand the variety of specialized resources within the Behavioral Health network, and the high-quality and value of the providers. Learn more about quality and costs by viewing the first two videos now. Videos on facing a mental health crisis, specialty resources and questions to ask will be available soon.

Watch Now

Coming Soon

  • Let’s Talk: The Value of a Network During a Mental Health Crisis
  • Let’s Talk: Specialty Resources Available In-Network
  • Let’s Talk: Questions to Consider When Choosing a Program or Facility

Aetna members can use DocFind to ensure they are always using an in-network provider. Members can simply log into their account on Aetna.com and select the type of provider they need and their location. The system will return providers in their area that are accepting new patients.

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
0
Display Hero
Off

How to protect yourself and your loved ones from measles

Bottom of the article

As the measles outbreak continues in the U.S., with more cases reported since the disease was declared eliminated in 2000, concern grows among public health officials, people who are immunocompromised and parents of young children. That’s because measles can cause very serious complications, especially in children under 5 years of age. These can include pneumonia, encephalitis and even death. Measles—also called rubeola—is caused by an extremely contagious, long-lasting virus which is spread through the air when an infected person coughs or sneezes. The measles virus can live up to two hours after a person who has coughed or sneezed leaves the area.

According to the CDC, 22 states have reported cases of measles this year. The largest outbreaks are occurring in Rockland county, New York; Washington state; New Jersey; Butte County, California; and Michigan. The infections were initially acquired as a result of travel abroad but have spread in the U.S. due to low immunization rates in certain communities.  Additional states reporting cases include Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Missouri, Nevada, New Hampshire, Oregon, Tennessee, and Texas. Most cases are affecting unvaccinated people younger than 19 years of age.

To ensure that you and your loved ones are unaffected by this outbreak, pay attention for initial symptoms of measles, which include:

  • High fever
  • Cough
  • Runny nose
  • Red, watery eyes (conjunctivitis)

Additionally, three to five days after the start of symptoms, a rash breaks out, beginning as flat red spots on the face, hairline, and spreading downward to the neck, trunk, arms, legs and feet. Smaller bumps also may appear on top of the flat red spots and become joined together as they spread. The fever may increase to as high as 104 degrees Fahrenheit when the rash appears.

Infected people can spread measles to others between four days before and four days after the rash appears.

Because the measles virus is highly contagious, health departments and physicians are urging anyone who thinks they may be falling ill with measles to contact their primary care provider before appearing in an office, urgent care center or emergency room.

“I can’t stress enough the importance of prevention through the very effective measles vaccination,” said William Fried, M.D., Senior Director, Aetna Clinical Solutions.

There is no specific treatment for measles. Supportive care recommendations include rest, fluids and acetaminophen for fever. The good news is that a safe and effective vaccine is available to prevent measles. It is recommended that children receive the vaccine in two doses: the first between the ages of 12 and 15 months and the second between the ages of 4 and 6 years old. Adults born after 1956 without evidence of immunity should also receive at least one dose of the vaccine, preferably within 3 days of exposure. Catch-up vaccination for unvaccinated children and adolescents is 2 doses at least 4 weeks apart.

Also, the CDC provides vaccine recommendations for college students, adults and international travelers. For more information on measles from the CDC, please visit https://www.cdc.gov/measles.

Click here to find a measles (MMR) vaccine provider.

Note: The Aetna Infectious Disease Response Team (IDRT) with Corporate Security continues to monitor this outbreak. 

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
1
Display Hero
Off

Aetna Is Ready to Help in a Natural Disaster

Bottom of the article

Your medicines and medical records may be the last thing on your mind when a wildfire nears your home, or a hurricane approaches, or flood waters rush closer and closer. Once you are on safer ground, however, you’ll realize you need them. Your doctor’s office or local pharmacy may not be available during a natural disaster, but your insurance company may be able to help.

Aetna has a long track record of stepping up to help its members caught in a natural disaster. Aetna’s business resiliency team keeps an eye on developing hurricanes, wildfires that are threatening communities, and other disasters. The team also monitors the news for events that strike unexpectedly, such as tornadoes. Aetna’s team is ready to move immediately, so members have one less thing to worry about.

Each disaster is different, of course. Aetna changes its normal policies during a disaster depending on many factors – the disaster’s effect on our members, the severity of the disaster’s impact on the local health care system, the geography, and any local, state or federal emergency request or declaration.

Replacing prescription medicines

Letting members refill prescriptions early is the most common way to help members during a disaster. This action can replace medicines that were lost, destroyed or left behind in an evacuation. Aetna’s pharmacy customer service teams are always ready to help a member caught in one of these situations.

If prescription mail order delivery is affected, Aetna can help members get their medicines at a local pharmacy. And if a member’s prescription had run out, Aetna can help them find an urgent care clinic where they can get a new prescription if needed.

Going to the doctor

If a widespread disaster forces doctor’s offices, clinics and even hospitals to close, Aetna can help members find care. Urgent care centers and walk-in clinics can handle many such issues. In some situations members may be able to see a doctor online through a telemedicine service. Aetna also may waive normal requirements, such as precertification for some services, if doctors can’t follow normal processes during a disaster.

Caring for your emotional well-being

Members can always access the behavioral health services that are part of their plan to help them cope with a disaster. In some circumstances, Aetna will open the behavioral health support of its Employee Assistance Program to everyone in the area affected by the disaster, whether or not they are members.

Extending deadlines

Depending on the disaster, Aetna may also extend deadlines for things like filing claim appeals.

Medical records

If you have an electronic health record set up through your insurer, hospital system or an online service, share that with any doctor caring for you during a disaster. If you don’t have access to your medical history, Aetna can provide physicians with claims information that will help them treat displaced members.

How do I get help?

If you’re an Aetna member and find yourself needing medicine or care during a disaster, call us. (If you’re not an Aetna member, check with your insurer.) Our customer service representatives can tell you what policy changes are already in place to help with the current disaster. We’re happy to help.

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
0
Display Hero
Off

Stay Safe During Flu Season

Bottom of the article

According to the Centers for Disease Control and Prevention (CDC), flu activity has increased sharply with most of the U.S. reporting widespread activity, similar to the flu season in 2014-2015, which was the most severe season in recent years. This year’s active strain, H3N2, is highly contagious.

Despite early reports that the flu vaccine may have reduced effectiveness, the CDC still recommends vaccination. If you have not been vaccinated yet this season, get vaccinated now. Most flu vaccine manufacturers have stated they have enough supply to meet anticipated demand for the current flu season. As demand increases, you may want to call your pharmacy in advance to see if flu vaccine is in stock.

How you can prevent the flu

  • Everyone 6 months & older should receive an annual flu vaccine

  • Avoid close contact with people who are sick

  • Wash your hands often with soap and warm water — if soap and water are not available, use alcohol-based sanitizer

  • Avoid touching your eyes, nose and mouth

  • Clean disinfect surfaces and objects that may be contaminated with germs like the flu

Signs and symptoms of the flu

  • Fever or chills (not everyone with the flu gets a fever)

  • Cough

  • Sore throat

  • Runny or stuffy nose

  • Muscle or body aches

  • Headaches

  • Fatigue

What to do if you get the flu

  • Stay home and avoid close contact with others until you have been without a fever for at least 24 hours (without fever-reducing medicine)

  • Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze

  • If you are very sick or at high risk of serious flu complications, ask your doctor about antiviral drugs as soon as possible – these medications are most effective if taken within 48 hours of getting sick, although they can still provide benefits if started later

  • The CDC does not recommend that you go to the emergency room when mildly ill. Read the CDC treatment recommendations.

Additional resources:

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
1
Display Hero
Off

Antibiotic Resistance: Toward Better Stewardship of a Precious Medical Resource

Bottom of the article

When 18-month-old Simon Sparrow woke up one morning in spring 2004, he was ill. By the afternoon, his face was swollen and he was having difficulty breathing. His parents brought him to the hospital, where he was diagnosed with septic shock and received antibiotics.

The next morning, Simon was dead.

Simon’s death was caused by methicillin-resistant Staphylococcus aureus, or MRSA. An indirect cause of Simon’s death was antibiotic resistance and the decades of overuse and misuse of drugs like methicillin, a synthetic version of penicillin.

Antibiotics are used to fight infections caused by bacteria. The overuse and misuse of antibiotics is accelerating the creation and spread of resistant bacteria, otherwise known as “superbugs.”

In a January 2018 white paper called, “Antibiotic resistance: Toward better stewardship of a precious medical resource,” Aetna International argues the antibiotic resistant bacteria crisis must be addressed through a global effort. The company believes the world must be better stewards of the antibiotics available today, while also working to develop more antibiotics for the future and address the underlying issues that led to the crisis.

“Stemming the rising tide of antibiotic resistance will take a global, multi-pronged effort. The industry must become better stewards of the antibiotics we have today, whilst working to develop more antibiotics for tomorrow,” said Mitesh Patel, M.D., a medical director at Aetna International. “A focus on harnessing big data will inform strategies that create better care for patients, as well as significantly decreasing the financial cost from antimicrobial resistance.”

The Centers for Disease Control and Prevention (CDC) estimates at least 2 million people become infected with antibiotic resistant bacteria each year in the U.S. Of those infected, about 23,000 dies from difficult to treat infections.

Although the biological causes of antibiotic resistant bacteria can’t be prevented, Aetna believes the societal causes – over-prescribing and misuse, use of antibiotics in agriculture, lack of research and poor hygiene and sanitation – can be addressed.

In the U.S., about 13 percent of outpatient visits, or 154 million visits each year, result in an antibiotic prescription, according to the Pew Charitable Trusts. Thirty percent of those prescriptions, or 47 million prescriptions, are deemed unnecessary.

Aetna sent letters to more than 1,100 clinicians in the United States in July 2017, who prescribed antibiotics to treat acute bronchitis, which is caused by a viral infection. The letters included information from the CDC on antibiotic resistant bacteria. This correspondence resulted in a significant percentage of the clinicians requesting further engagement with Aetna to tackle the issue.

The white paper also describes how health systems across the world are working to address the antibiotic resistant crisis. In India, multiple factors, such as high burden of disease, poor public health infrastructure, rising incomes and unregulated sale of cheap antibiotics, led to the country becoming one of the world’s largest consumers of antibiotics.

Indian Health Organization, an Aetna company, is taking a three-pronged approach to combat this. There is an emphasis on antimicrobial stewardship in clinical training. Audited medical consultations also include checking antibiotic prescriptions for dosage, duration and rationale for use. Physicians are also identifying and correcting antibiotic usage during consultations.

Aetna is also working with providers and members to increase awareness and education about antibiotic resistant bacteria and appropriate antibiotic use. The approach has led to antibiotic utilization across Aetna International’s membership to drop from 27 percent in 2014 to 18 percent in 2016.

Other organizations have also starting to take an increased look at combatting the antibiotic resistant bacteria crisis, according to the white paper. After Simon’s death in 2004, his mother partnered with the University of Chicago Medical Center and found the MRSA Research Center. The Research Center seeks to prevent, control and treat MRSA through scientific and clinical research, according to its website.

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
0
Display Hero
Off

Helping employers keep their promise to their retirees in Medicare Advantage Employer Group Waiver plans

Bottom of the article

Retiree health coverage is an important component of the benefit packages that employers and unions offer their workers. Yet, today, only 25 percent of employers with 200 or more employees offer health benefits for their retirees — a decrease from 40 percent in 1999 and 66 percent in 1988.Claxton G, Rae M, et al. 2017 employer health benefits survey. Kaiser Family Foundation. September 2017. Available at: http://www.kff.org/health-costs/report/2017-employer-health-benefits-survey/.

The employers that continue to provide coverage are increasingly seeking innovative ways to manage costs while offering high-quality retiree benefits.  Medicare Advantage Employer Group Waiver Plans (MA-EGWPs) are proving to be an increasingly attractive option.

MA-EGWPs provide employers the opportunity to fulfill their promise to maintain consistent coverage for their former employees.  EGWP Preferred Provider Organizations (PPOs) allow employers to maintain this commitment, regardless of where their former employees choose to live in retirement.  While the individual Medicare Advantage market is comprised mostly of local health maintenance organization (HMO) plans, over 70 percent of MA-EGWPs are PPO plans, tailored to serve retirees living in widespread areas.Avalere Health analysis using enrollment data released by the Centers for Medicare & Medicaid Services. July 2017.

As part of the 2019 Medicare Advantage (MA) and Part D Advance Notice, however, CMS is proposing to cut payments to these EGWP plans. CMS is proposing to fully transition in 2019 to using only individual market plan bids to set payments for MA-EGWPs. Given the differences in the composition of the EGWP and individual MA markets, using bids that mostly reflect HMO structures to set payments for plans that mostly offer PPO structures could cause unintentional coverage disruption for retirees.

As CMS seeks to finalize this policy, Aetna is urging the agency to take into account the dynamics of the employer retiree market and determine payments to this market accordingly. Specifically, to maintain predictability and stability, CMS should implement an adjustment that takes into account the difference in the benefit structure of HMOs vs. PPOs, even within the EGWP market.  In doing so, CMS would ensure that EGWP HMOs are not over-paid and EGWP PPOs are not under-paid. We are also asking that CMS phase-in any final payment changes to this program over the next two years rather than one year.

Millions of people depend on MA for quality, patient-centered health care.  With over 3.4 million MA-EGWP enrollees today, it is important CMS take steps to minimize disruption to this program and help employers maintain this seamless form of coverage to their former employees.

For more information, see a recent analysis conducted by Avalere, “The Future of the Medicare Advantage Employer Group Waiver Plan Market.”

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
1
Display Hero
Off

Multidisciplinary care teams surround members with support

Bottom of the article

In Arizona, a member was struggling with obesity and severe lower back pain, while also serving as the sole provider for her family and the primary caregiver for her grandmother, who has Alzheimer’s Disease. Navigating the health care system and trying to achieve her health goals was difficult.

The multidisciplinary care team, a new Aetna program aimed at helping members with complex health problems break down barriers to access care, was the answer. The teams, which are fully integrated with providers in the community, help high-risk members with various health and social needs, from chronic disease management to access to transportation.

“Doctors are seeing the value of this care model and are recommending the program to their patients,” said Brigitte Nettesheim, vice president of transformative markets in Consumer Health & Services. “We’re hearing powerful anecdotes about what a difference this approach is making in people’s lives.”

The program is currently being offered by Texas Health Aetna, Banner|Aetna and Innovation Health.

For the member in Arizona, the multidisciplinary care team helped get her the care she needed and connected her with resources in the community to help care for her grandmother. A nurse case manager referred her to a local diabetes educator, connected her to a new primary care doctor and specialist and signed her up for aquatic exercise classes to help with weight loss and back pain.

The result of Aetna’s holistic approach to care has been nothing short of life changing, according to the member.

“I was feeling so overwhelmed and hopeless when I received that first call from the care team that I didn’t know where to begin,” she said. “I feel like an angel has answered my prayers.”

As part of a multidisciplinary care team, local nurse case managers, social workers, pharmacists, diabetes educators, certified medical assistants and medical directors analyze data to proactively identify and solve member needs. For example, nurse case managers talk with members face-to-face and by phone to help them find the care and community-based resources they need.

Multidisciplinary care teams do not provide medical care to members; instead, they help members get the care they need.

“This program is very much a local strategy to engage with our members,” said Catherine Czarnecki, executive director of Clinical Transformation in Joint Venture Markets for Aetna. “It meets people where they are in their health journeys.”

Hide Media Contacts (Sidebar)
No
Press Release
Hide Share
Off
"Likes" Count
0
Display Hero
Off