Physician Engagement with Aetna 'Care Considerations' Pays Off in Medical Home Pilot

Summary: Aetna's practice of sending its providers periodic "care considerations" --- detailed clinical data that identify opportunities to improve care --- has been formalized in its patient-centered medical home (PCMH) pilot with Partners in Care (PIC), explains Dr. Don Liss, the regional medical director of Aetna's mid-Atlantic region. PIC providers' engagement with the care considerations is now a factor in the pay for performance aspect of the pilot. Dr. Liss shares some short-term indicators that demonstrate that the PCMH is working as well as the long-term view for medical home ROI, which can vary greatly for payors and providers. Dr. Liss, along with George Chedraoui, healthcare leader with IBM and immediate past president of Bridges to Excellence, shared different viewpoints --- the healthcare payor and purchaser --- and their strategies for achieving an ROI from the medical home during, Medical Home Metrics and Measurements for Achieving ROI.