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Moving From Volume to Value: Transforming Care with Provider and Consumer Engagement


Transcript - Moving From Volume to Value: Transforming Care with Provider and Consumer Engagement 

Improve care coordination.

Accountable care is really a change in the way that we practice medicine and how we take care of populations. And so everybody took care of a piece of a person and nobody thought about the whole person in one view. And accountable care really is sort of a change in how we focus on the entire person and the entire population.

The care team, now, is incredibly important. It is so much more than just the patient and the physician. They help the transitions of care from the hospital back in to the office. They help make sure that the patient has anything that they might need to help overcome roadblocks.

We have to be able to try to keep people healthy and understand what their health needs are – potentially better than they do.  And that means that we’re going to need to in fact understand what their health challenges are even if they feel well and have not interacted with the health system. 

Increase data transparency.

By bringing together the data that Aetna provides us – the lab data from our partners, the physician practice data, the hospital data – we’re able to get a more complete picture of what’s going on with that individual patient, so that we can take better care of them.

Accountable care is the aligning of the goals and the incentives for everybody on the team, and the transparency to understand what everybody’s doing, what everyone’s working on.

Enhance patient relationships.

A lot of what we’ve done in the past, in our sickness care, has been centered around the needs of the doctors or the needs of the payers or the needs of the pharmacist. What if we started flipping that around and saying, “What do the patients need?”

Ultimately that’s who we’re serving and that’s what this new model does. It puts the patient front and center.

The new coordinated care model has several different advantages. The model is designed to not only be convenient, but be considerate of the patient and the patient’s schedule, and build the team around that. 

Aetna brings to the table a vision I believe of wellness for patients and with their focus being that patient’s get the assistance they need from their insurance company. We have patients say all the time to the care managers, “I never knew my insurance company would help me like this.”