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Aurora Health Care has joined with Aetna to bring employers a new type of commercial health plan, the Aurora Accountable Care Network, which offers businesses a price guarantee
Aurora Health Care has joined with Aetna to bring employers a new type of commercial health plan, the Aurora Accountable Care Network, which offers businesses a price guarantee to control costs.
The price guarantee entails the companies committing that the employer's costs won’t go up by more than a certain percentage for three years.
“We arrive at what the percentage guarantee will be by reviewing two to three years of their past claims experience,” says Sherry Sanderford, Aetna communications director.
Employers must sign a three-year agreement.
Cost savings will be specific to each employer, with the potential for an average 10% reduction based on the employer’s past claims expenses, according to the companies. The plans with Aetna will be effective beginning Jan. 1, 2013.
The Aetna plans offered through the Aurora Accountable Care Network are designed for Wisconsin small and mid-sized businesses. Solutions for large, self-funded employers are also available. The plans are fully insured and feature two tiers of benefits and copays.
“Members who seek care from tier 1 - the Aurora Accountable Care Network - will have lower copays, deductibles and coinsurance than those who seek care outside that network,” says Sanderford.
Aurora’s integrated system includes more than 1,500 physicians, 15 hospitals and 160 clinics in eastern Wisconsin and northern Illinois. Employees also will have access to care managers, who can schedule appointments, help patients connect with physicians and follow up with patients who have chronic or complex conditions.
“As part of the agreement, Aurora commits to meeting certain metrics around quality and efficiency,” says Sanderford.
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