GREAT NECK, NY – The North Shore-LIJ Health System and Aetna today announced a joint agreement that covers approximately 30,000 commercial members in a value-based collaboration designed to enhance patient care coordination, improve quality health outcomes and reduce healthcare costs.
The agreement features a new payment model to reward North Shore-LIJ Premium providers 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 heart failure; and
- appropriateness of antibiotic use.
Under the agreement, care for Aetna members will be coordinated through North Shore-LIJ Premium IPA, an integrated network of over 5,500 primary care and specialty physicians as well as other healthcare professionals in the New York metropolitan area. Members can continue to use North Shore-LIJ’s network of 19 hospitals, more than 400 outpatient practices and a full continuum of long-term care, rehabilitation, homecare, hospice and other services on Long Island, New York City and Westchester.
“This new collaboration between North Shore-LIJ and Aetna further expands our efforts to manage population health, promote patient-centered care and increase Aetna members’ access to a full spectrum of high-quality, high-value care,” said Howard Gold, executive vice president of managed care and chief business development officer at North Shore-LIJ. “This framework allows us to follow patient outcomes more closely and better coordinate care as we align quality with payment incentives.”
“Working together, health care providers and health plans can improve care for the people we serve,” said David Kobus, senior vice president of Aetna’s New York market. “We’re excited to collaborate with North Shore-LIJ to drive better patient outcomes and satisfaction through the support of their personal health care system.”
“North Shore-LIJ Premium is a comprehensive provider network comprised of employed and voluntary physicians that can integrate delivery of services across the health system’s care continuum,” said Thomas McGinn, MD, senior vice president and chair of medicine at North Shore-LIJ. “Through initiatives such as Aetna’s collaborative, value-based model, participating physicians are aligning around quality and efficiency as we transition to a value-based model of care.”
North Shore-LIJ Care Solutions oversees the health system’s care management strategy and operations, and coordinates clinical care for high-risk patients who are the intensive users of services. To address the complexity of delivering services across the continuum of care, North Shore-LIJ’s information technology team developed innovative electronic care management software called Care Tool. Care Tool is used to support care coordination and outreach for complex, high-risk patients and helps patients meet their health and personal wellness goals.
"Aetna’s collaborative agreement with the North Shore-LIJ Health System will promote better health outcomes and improve access to affordable, high-quality health care for our members who choose this system as their primary healthcare provider," added Terry Golash MD, senior medical director, Aetna, New York.
About North Shore-LIJ Health System
One of the nation's largest health systems, North Shore-LIJ delivers world-class clinical care throughout the New York metropolitan area, pioneering research at The Feinstein Institute for Medical Research, a visionary approach to medical education highlighted by the Hofstra North Shore-LIJ School of Medicine, and healthcare coverage to individuals, families and businesses through the CareConnect Insurance Co. Inc. North Shore-LIJ cares for people at every stage of life at 19 hospitals and more than 400 outpatient physician practices throughout the region. North Shore-LIJ’s owned hospitals and long-term care facilities house more than 6,400 beds, employ nearly 11,000 nurses and have affiliations with about 10,000 physicians. With a workforce of about 54,000, North Shore-LIJ is the largest private employer in New York State. For more information, go to www.northshorelij.com.
Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46 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 www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews
Matthew Wiggin, Aetna