Among its home- and community-based care initiatives, Aetna, the country’s largest health care company, is doubling down on the use of telehealth. They are leaning into the CVS HealthHUB network, which offers seniors a range of services, from preventative care to acute care. They are also investing in “cost-effective care management programs” and expanding their relationships with home-centric partners.
Home Healthcare News’ recent article entitled “Aetna Medicare CMO Outlines Aging-in-Place Agenda” says that as of June 30, Aetna served about 9.8 million Medicare members nationwide. Aetna Medicare’s overall footprint stretches across 46 states, with plans for dually eligible individuals available in over 24 states.
As CMO of Aetna Medicare, Dr. Jamie Sharp is tasked with improving seniors’ care experience and outcomes. Along with her team, she also supports Aetna’s value-based provider relationships.
“We also have a real focus on driving health equity across the Medicare Advantage (MA) space for our members,” Sharp, an internal medicine physician who spent her early career working in the hospital setting, said.
One of Aetna’s aging-in-place initiatives is its Healthy Aging support program. This interactive program started a year ago and is designed to support Aetna’s members with chronic diseases, by giving them tools to better self-manage their conditions. As part of the program, members participate in a series of virtual sessions, either as part of a group or individually.
Other home-focused care management initiatives include its readmission prevention programs, which are focused on giving high-risk members and their families “all the resources they need” to avoid costly re-hospitalizations.
“After they have an acute event and end up in a hospital, how do you transition them back home, helping them stay at home while getting back to their previous life?” Sharp said. “That might be making sure they have the food they need. Do they need transportation to pick up their medication? Have they made their follow-up appointments with their providers and their specialists?”
CVS has made converting more of its stores into health care centers a big priority. This makes a lot of sense for the company, which seeks to create more synergy between its brick-and-mortar locations and its insurance arm. The HealthHubs play a significant part in that mission. CVS expects to have 1,500 hubs in operation by the end of 2022. As it invests in the network, it will also close hundreds of stores not core to its health care strategy, CVS executives recently explained.
Aetna’s aging-in-place plan, in particular, includes a relationship with Papa, the in-home companionship startup that has raised more than $240 million since launching. Several other major insurers have also inked partnership agreements with Papa, recognizing the value of addressing social determinants of health.
“Companionship support, decreasing that social isolation that’s been present during the pandemic is a reason we’ve expanded that relationship with Papa,” Sharp said. “[We can] bring in those companions, make sure that they can meet with a member, take them grocery shopping, go on a walk with them. Do that maybe 10 hours a month, giving members the support they need, so they can stay at home, stay safe.”
Meanwhile, as far as telehealth, all Aetna MA plans will cover telehealth for primary care, urgent care, specialty care, and mental health in 2022, which also helps enable aging-in-place.
“As the pandemic came up, we all realized that telehealth had to be a priority — and also quickly realized that seniors were more than willing to take advantage of it,” Sharp said. “We saw those claims go up, and we were happy to see that they were able to tap into that opportunity.”
Reference: Home Healthcare News (Dec. 5, 2021) “Aetna Medicare CMO Outlines Aging-in-Place Agenda”