[July 01, 2015]

Aetna, University of Chicago Medicine Form Oncology Medical Home

The University of Chicago Medicine and Aetna (NYSE: AET) announced a collaboration today to create an oncology medical home that is designed to improve the care experience for cancer patients. This approach allows teams of cancer specialists to work together to care for a patient with a cancer diagnosis. The model will give UChicago Medicine the responsibility to arrange appropriate care that is continuous and proactive.

"The University of Chicago Medicine is excited to be working with a forward-thinking payer like Aetna to explore a more innovative payment model for cancer care," explained gastrointestinal cancer specialist Blase Polite, M.D., associate professor of medicine at the medical center. "We all agree we must move from a volume-based system to one based on quality and value of care for our patients, their families and their employers. This payment model is a step in that direction and we look forward to working with Aetna to help refine what we see as a model for the future of cancer care payment."

The model is part of a strategic decision to transition from fee-for-service reimbursement to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency and duplication of services. These arrangements also make it easier for people to get the care they need. In value-based models, doctors and hospitals are paid for helping keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care. Nationally today, about 5.8 million Aetna members receive care from doctors committed to the value-baed approach, with approximately 30 percent of Aetna claims payments going to doctors and providers who practice value-based care. Aetna has committed to increasing that number to 50 percent by 2018 and 75 percent by 2020.

"We understand that cancer treatment can be the hardest experience that our members will ever have to go through," said Michael Kolodziej, M.D., Aetna's national medical director for Oncology Solutions. "This oncology medical home with the University of Chicago Medicine will help give our members optimal care and an optimal patient experience."

The operating principles of the UChicago Medicine and Aetna oncology medical home include:

• An orientation to the whole person. A personal physician from UChicago Medicine will be responsible for providing or arranging for all of a patient's health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care and end-of-life care.
• Evidence-based, personalized medical care. The UChicago Medicine team will focus on designing treatment regimens based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice by utilizing University of Chicago's Clinical Pathways, which were designed by teams of surgeons, medical oncologists, hematologists and radiation oncologists to improve quality and outcomes.
• Coordinated and integrated care. Across all elements of the complex health system, care will be facilitated to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
• Quality and safety. Quality and safety will be a focus of care, including use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
• Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement begins on July 1, 2015.

About the University of Chicago Medicine

The University of Chicago Medicine & Biological Sciences is one of the nation's leading academic medical institutions. It comprises the Pritzker School of Medicine, a top 10 medical school in the nation; the University of Chicago Biological Sciences Division; and the University of Chicago Medical Center, which recently opened the Center for Care and Discovery, a $700 million specialty medical facility. Twelve Nobel (News - Alert) Prize winners in physiology or medicine have been affiliated with the University of Chicago Medicine. Visit our research blog at sciencelife.uchospitals.edu and our newsroom at uchospitals.edu/news or find us at @UChicagoMed or Facebook.com/UChicagoMed.

About Aetna

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

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