Riverside Health System and Aetna form accountable care organization alliance

Health insurer Aetna and Riverside Health System in Newport News have formed an accountable care organization (ACO), a new health insurance model designed to improve health-care outcomes and reduce overall cost.

The ACO will be offered through a new health plan, Aetna Whole Health, which will be available starting this year to small groups and next year to individuals through the federal Health Information Exchange.
“This is a new type of relationship where the health insurer and the delivery network work together to share data and share outcomes to achieve better health and better costs for people who are in the ACO,” Craig Connors, vice president, managed care operations, for Riverside Health System said Tuesday in a phone interview.

In ACO alliances, providers are responsible for improving patient care and lowering costs through better preventative care and coordination of physicians, hospitals and other providers.

Connors said ACOs are designed to meet three goals: improve each patient’s experience, improve health of the community and lower the per capita cost of health care.

This is Aetna’s third ACO in Virginia.

“This is an exciting development for Aetna members in the coastal Virginia area,” Tom Grote, president of Aetna’s Virginia, Maryland and Washington, D.C. operations, said in a statement. “Working with health systems like Riverside, we’re redefining the relationship between insurers and providers. The end result will be better, more efficient and more affordable care.”
Aetna, which has about 500,000 Virginia members, has previously announced accountable care arrangements with Inova Health System and Carilion Clinic.