Aetna, Cleveland Clinic Launch a New-Model ACO, Co-Branded Insurance Plan

Aug. 19, 2020
The leaders of Aetna and the Cleveland Clinic on Aug. 19 announced the creation of a potentially groundbreaking new accountable care organization (ACO) model that will advance health plan/provider collaboration in the Cleveland marketplace.

The leaders of the Hartford, Conn.-based Aetna and the Cleveland Clinic on Aug. 19 announced the creation of a potentially groundbreaking new accountable care organization (ACO) model that will advance health plan/provider collaboration in the Cleveland, Ohio healthcare marketplace.

In a press release posted to their website, Aetna leaders on Wednesday morning reported that “Cleveland Clinic announced today a new multi-faceted collaboration with Aetna, a CVS Health Company (NYSE: CVS), to form an ACO model and offer new plans and programs featuring Cleveland Clinic providers. The collaboration includes the launch of a co-branded insurance plan, which could reduce healthcare costs for participating employers, an expanded relationship nationwide to provide members enrolled in Aetna commercial plans access to second opinions by Cleveland Clinic for certain conditions, and the deployment of Cleveland Clinic’s Cardiac Center of Excellence (COE) program to Aetna plan sponsors.”

The press release quoted Steven C. Glass, Cleveland Clinic’s CFO, as stating that, “Given the current economic climate, employers are looking for a cost-effective, high quality insurance plan that also provides access for their employees to coordinated care and advanced medical expertise. Cleveland Clinic is committed to improving the health and wellbeing of Aetna members, and we look forward to working together to deliver value-based health care to an expanded patient population,” Glass said.

And Angie Meoli, senior vice president, network strategy and provider experience at Aetna, was quoted in the press release as saying that, “As part of CVS Health’s goal of becoming the most consumer-centric health company, we are facilitating access to high-quality health care where and when consumers need it. Cleveland Clinic is renowned for delivering exceptional health care, and our new collaboration will enable our members to receive the personalized and coordinated care they need to get and stay healthy.”

“The Aetna Whole Health – Cleveland Clinic co-branded commercial plan offers Northeast Ohio employers and their plan members positive clinical outcomes, improved experience and reduced total cost of care,” the press release stated. “Care is delivered in a coordinated approach through Cleveland Clinic’s network of employed, aligned and affiliated providers. Under the new plan, Aetna members can receive care from the Cleveland Clinic Quality Alliance network of employed and independent community physicians or at any Cleveland Clinic facility. Cleveland Clinic will be rewarded for achieving quality and cost targets. The Aetna Whole Health℠ – Cleveland Clinic plan provides employers a cost-effective offering beyond Aetna’s typical broad network plans, while also giving members access to Cleveland Clinic’s care providers. Cleveland Clinic and Aetna participating employers could save as much as 10 percent in health care spending by choosing the new plan over a current Aetna broad network plan.”

The press release also noted that “The organizations have also worked together to expand these savings nationwide, offering Aetna commercial members a new program with streamlined scheduling for specialty services and access to health-plan directed, virtual second opinion services at Cleveland Clinic through a dedicated specialty referral line for Aetna members. Aetna care managers will work one-on-one with members to navigate their specific health needs and personalized care plans.”

The organizations noted that “Fully insured and self-insured employers in Ashtabula, Cuyahoga, Geauga, Lake, Lorain, Medina, Portage, Stark, Summit, and Tuscarawas counties can begin purchasing Aetna Whole Health℠ – Cleveland Clinic plans beginning in the fall of 2020, depending on segment and group size. This new multi-faceted relationship will involve additional programs and expanded services,” the press release added. “For example, the organizations are also launching a Cardiac COE program to offer Aetna plan sponsors across the country cardiac care at Cleveland Clinic, which is home to the number 1-rated heart program in the nation for the past 26 consecutive years as ranked by U.S. News & World Report. The Cardiac COE program is designed to offer patients improved clinical outcomes as well as faster return to work and other activities of their daily lives.”