Sutter Health and Aetna to Establish New Health Plan in Northern California

Posted on Jun 13, 2017 in Expanding Access, Transformation

Sutter Health, a not-for-profit health care system in Northern California, and Aetna today announced plans to launch a jointly owned health plan. This new collaboration, the first of its kind in Northern California, will bring together Sutter Health’s network of nationally recognized, high-quality doctors and hospitals with Aetna’s leading health plan expertise, cutting-edge data, analytics and health information technology, and shared care management capabilities.

This joint venture will deliver a differentiated, personalized experience for members and is designed to help lower the cost of care, resulting in competitively priced products. Sutter Health and Aetna anticipate offering self-insured commercial products starting mid-2018 in the greater Sacramento, Central Valley and Bay Area communities, as well as fully insured PPO products to follow in early 2019, pending regulatory approval.

This new company will complement Sutter Health’s and Aetna’s current products by providing more choices to Northern California’s commercially and self-insured populations.

By equally sharing ownership and accountability, Sutter Health and Aetna aim to integrate the continuum of care delivery, from wellness to disease management, care coordination, and access. It will also streamline administrative services for members.

This new approach to care management will focus on enhancing member engagement through combined data analytics that identify at-risk patients sooner and provides them with earlier access to care by expanding access to alternative sites of care, and using advanced population health technology to help members better manage chronic and other health conditions.

“We are excited to partner with Sutter Health on this joint venture,” said Mike Bahr, Aetna’s senior vice president of local markets and territories. “With Sutter Health, we believe we have found a strong partner that shares our vision to transform health care in Northern California by providing members with a simpler, more personal experience.”

Through this new relationship, Sutter Health and Aetna will work together to integrate health care and insurance coverage that provides members with the services they need as quickly and efficiently as possible.

“Patients benefit when providers and health plans share resources and work together,” says Phil Jackson, Sutter Health’s CEO of Health Plan Products. “Our Sutter Health and Aetna insurance product offerings will provide employers with new self-funded and fully insured PPO options in Northern California.”

Currently, Sutter Health-affiliated providers care for more than three million Northern California residents. Aetna provides health care benefits to approximately 415,000 members in Northern California.

Aetna projects to have at least 75 percent of its claim payments in value-based models by 2020.

 

 

Posted by on Jun 13, 2017 in Expanding Access, Transformation | Comments Off on Sutter Health and Aetna to Establish New Health Plan in Northern California