• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Aetna Expands Availability of Network Option Based on Clinical Performance and Cost-Effectiveness; Aexcel(SM) Available in 11 New Markets; Nearly 300,000 Members to Date

Posted on: Tuesday, 26 July 2005, 09:01 CDT

Aetna (NYSE:AET) announced today the geographical expansion of its network option featuring Aexcel-designated specialist physicians. Aetna applies Aexcel designation to certain specialists who in addition to being part of Aetna's network, meet thresholds for clinical performance and cost efficiency. Effective January 2006, Aetna's Performance Network featuring Aexcel-designated specialists will be available in a total of 20 markets.

The 11 new markets are Arizona; Austin and San Antonio, TX; Chicago, IL; Northern/Central Valley, CA; Cleveland and Columbus, OH; Maine; and Tampa, Orlando and South Florida (Dade and Broward Counties). Markets are selected based on the size and performance of the area's specialist network and significant interest by employers in supporting this initiative. Aetna's network option can be offered by employers on a stand-alone basis or as a choice among Aetna's other networks.

"Through Aexcel, Aetna is engaging key stakeholders in the health care system in an innovative solution that provides access to specialists who have met clinical performance measures and demonstrated effective use of health care resources," said Donald Storey, M.D., Aetna's senior medical director for Aexcel. "We are working together with our constituents to deliver a value-based, cost-effective network option that has been very well-received. Aexcel currently has 25 customers and nearly 300,000 members."

Aetna developed a rigorous evaluation process to identify physicians in 12 specialties who have shown they deliver more cost-effective care. Doctors within those specialties were evaluated using measures of clinical performance and efficiency in their use of health care resources. The specialties included in Aexcel are cardiology, cardiothoracic surgery, gastroenterology, general surgery, obstetrics/gynecology, orthopedics, otolaryngology, neurology, neurosurgery, plastic surgery, vascular surgery and urology.

"Using data from Aexcel is helping us work with Aetna, corporations and physicians to re-engineer the delivery of health care. We share a common commitment to improve safety, quality and patient satisfaction while reducing cost," said Robert S. Mecklenburg, M.D., chief of the Department of Medicine at Virginia Mason Medical Center in Seattle.

Constituent feedback about Aexcel is important to Aetna. Since Aexcel's inception, Aetna has maintained dialogue about the designation and market selection process with employers and the medical community.

"REI is about outdoor recreation and healthy lifestyles, so it's important to us that we offer high-quality, cost-effective care to help our employees stay healthy and manage their health care expenses," said Giselle Sampson, employee benefit manager for Recreational Equipment, Inc. (REI), a national, Seattle-based supplier of specialty outdoor gear and clothing. "Aexcel helps us provide that level of care for our employees in each market where it's available and is an important element of our benefits strategy."

Consumers often have little access to independent, objective information when they choose specialists. Aexcel is one of a series of industry-leading initiatives from Aetna designed to address rising medical costs, maintain access to quality care, and help consumers make more informed health care decisions. All are complemented by Web-based decision support tools to help members get more from their health care dollars. This includes health care pricing and quality tools, online claims and fund tracking, credible health information and health risk assessments.

Aexcel-designated specialists are the centerpiece of Aetna's Performance Network, a network option that also includes Aetna participating primary care providers, hospitals and physicians in non-Aexcel specialties.

In 2005, Aexcel was made available in Atlanta; Houston; Metropolitan DC (MD/DC/Northern VA); Metropolitan NY/Northern New Jersey; Los Angeles; and Connecticut. In 2004, Aexcel was introduced in Seattle/Western Washington; North Florida; and Dallas/Fort Worth.

As one of the nation's leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 14.4 million medical members, 12.8 million dental members, 9.0 million pharmacy members and 14.0 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 672,000 health care professionals, including approximately 400,000 primary care and specialist doctors and 4,084 hospitals. For more information, please visit www.Aetna.com. (Figures as of March 31, 2005)

Source: Business Wire

More News in this Category