Aetna unveiled plans to further expand a key program in working with hospitals.
The Aetna Clinical Collaboration Program aims to improve outcomes for members in Medicare Advantage plans by reducing hospital readmissions and unnecessary emergency room visits. Through the program, Aetna places nurses on-site to assist hospital staff with care transitions.
These nurses support patients being discharged who are making the shift to a skilled nursing facility or their homes to reduce the provider's burden during the process, according to the announcement. Aetna expects to have the program in place at 10 hospitals by the end of this year and is currently working with AdventHealth Shawnee Mission, Houston Methodist and WakeMed Health & Hospitals.
“Hospital discharge is one the most important—and vulnerable—moments in a patient’s journey,” said Aetna Chief Medical Officer Ben Kornitzer, M.D. “Patients may be managing new diagnoses, complex medications, and follow-up needs, all while coping with the stress of transitioning back home or to a new facility."
"By embedding Aetna nurses within hospitals, we’re partnering with care teams to ensure that members are supported every step of the way and have the right services to stay well and avoid complications that could lead to readmission," Kornitzer said.
Aetna said the first implementation of the program began earlier this year, and about a quarter of members in program are "actively engaged" with a care manager through the insurer.
It also noted a 2024 study from the Agency for Healthcare Research and Quality, which found that close to 20% of Medicare enrollees are readmitted to the hospital within 30 days. Aetna estimates that once its Clinical Collaboration Program is in place, it will reduce 30-day readmission rates and lengths of hospital stays by 5% annually.