Aetna Announces Innovative Hospital Network – A SBPPO?

In an earlier posting we described the phenonomen of PPO Networks within a PPO Network, which some refer to as a  SBPPO. Could this be an Aetna SBPPO? You decide.

Since its launch in 2011, Aetna’s hospital performance network has been helping large employers save on health care costs.  Starting in 2012, we’re bringing the power of this offering to self-funded Middle Market customers as well.

 How can it help my clients save on medical costs?
The concept of the hospital performance network is simple. It puts the power of choice in the member’s hands and brings together six essential components that deliver better results through improved quality and cost savings:

  • Plan design: Lower costs for members following certain behaviors
  • Network: Access to a select, yet widely accessible, network of Aexcel® specialists and high performing hospitals, who have met special standards for quality and cost effectiveness.
  • Incentives: Drive healthier behaviors and use in-network providers
  • Care management: Personalized and integrated care featuring motivational interviewing techniques to maximize participation and results
  • Communications: Tools to help educate members before, during and after enrollment
  • Member services: Specially trained staff helps guide members to designated providers, share cost information and maximize benefits plans 

With non-emergent hospital care accounting for 16% of total medical costs, hospitals in our hospital performance network have the potential to save up to 7% of total medical costs (average 2%).  (Source: 2011 Aetna Informatics preliminary analysis and business assumptions)


The power of choice
When members use a provider in the hospital performance network, they will typically pay less out of pocket than using a provider who is not in the hospital performance network.  Our online DocFind® tool does the work for them by identifying the Aexcel specialists and designated hospitals in their local area.


Plus, your employees get the benefit of Aetna’s world-class support system

  • A secure member website and innovative tools that that help your employees manage their health and finances with real-time, personalized health information and cost comparisons
  • Knowledgeable Member Services staff
  • And much more 

As of January 2012, Aetna’s hospital performance network will be available in the following markets:

  • Arizona (Phoenix)
  • California (Central Valley, Los Angeles, Northern California, San Diego)
  • Connecticut
  • District of Columbia (Washington, DC)
  • Florida (Brevard County, Northern Florida, South Florida – Palm Beach and Broward Counties, Tampa)
  • Georgia (Augusta, Savannah)
  • Illinois (Chicago)
  • Indiana (Indianapolis)
  • Kentucky (Louisville)
  • Maine
  • Massachusetts
  • Nevada (Las Vegas)
  • New Hampshire (Southern)
  • New Jersey (Northern, Southern)
  • New York (Metro NYC, Upstate)
  • North Carolina (Charlotte, Winston-Salem, Raleigh-Coastal-Greenville)
  • Ohio (Cincinnati, Cleveland, Toledo)
  • Oklahoma (Oklahoma City, Tulsa)
  • Pennsylvania (Central, Lehigh-Berks, Northeast Scranton, Southeastern, Philadelphia)
  • South Carolina
  • Tennessee (Eastern, Nashville)
  • Texas (Austin, Houston, San Antonio)
  • Virginia (Hampton Roads, Richmond, Roanoke)
  • West Virginia
  • Wisconsin (Southeastern)