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Clinically Integrated Organization (CIO) Model



Clinically Integrated Organization (CIO) Model




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Aetna (NYSE: AET) and Carolinas HealthCare System (CHS) today announced an innovative new approach to care in the Charlotte area. Beginning April 1, Aetna and CHS are using a clinically integrated organization (CIO) model to support stronger patient-centered medical homes and other accountable care efforts. Using CHS’s broad system of integrated facilities and physicians, the collaboration is designed to give Charlotte-area employers better health care options for their employees by: Creating a more coordinated, personalized experience for patients; Saving employees money when they use providers in CHS’s clinically integrated care network; and Improving health care outcomes. The arrangement is one of Aetna’s first accountable care collaborations designed specifically to offer self-insured customers the quality improvement and cost-saving benefits available through these models. It also is available to fully insured customers. “Aetna is working to change the health care system to one that focuses on quality and affordability, not just volume,” said Margie Maxwell, president of Aetna’s operations in North Carolina, South Carolina, Tennessee and Arkansas. “Working with organizations like Carolinas HealthCare System, we’re helping our members receive the care they need to live healthier, more productive lives. We’ll continue to seek collaborative opportunities in an effort to improve efficiency, quality and customer satisfaction.” As part of the collaboration, CHS and Aetna will review trends among members cared for in the model and develop plans to improve them where needed, such as: Increasing prescribing of generic drugs by providers; Maintaining CHS’s performance at national benchmark levels for annual hemoglobin and lipid testing for members with diabetes; and Increasing CHS’s current performance to national benchmark levels for annual eye exams for members with diabetes, and breast cancer screening. Patient Centered Medical Homes Offer Integrated Care Approach “Carolinas HealthCare System has a tradition of focusing our efforts to deliver high-quality health care services and has been a leader in the movement to the medical home approach,” said Joseph G. Piemont, president and chief operating officer of CHS. “This collaboration with our comprehensive, coordinated system of care is beneficial for patients.” A medical home is a team of physicians and other clinicians in one practice working together to provide comprehensive medical care on an ongoing basis, resulting in more efficient and effective care. There are 77 patient-centered medical homes within CHS, each accredited by the National Committee for Quality Assurance (NCQA). Customers using the new model will benefit from CHS’s integrated approach to high-quality health care. It will help them navigate comfortably through the course of prevention, diagnosis and treatment, using a process that requires exceptional teamwork and collaboration. CHS will also provide Aetna members with a single phone number for scheduling appointments with CHS physicians, as well as online appointment scheduling. Members also can use a mobile application that lists wait times at 21 CHS urgent care locations and 14 emergency departments. Aetna is working with health care organizations across the country to develop products and services that support value-driven, patient-centered care. Aetna’s solutions help all types of patients, regardless of payer. Source: Aetna Project Name Clinically Integrated Organization (CIO) Model Location USA Commence 2013 Completion N/A Estimated Investment N/A Capacity N/A Key Players Aetna, Carolinas HealthCare System