Aetna, Baptist Health System and HealthTexas Link Up for Accountable Care

San Antonio-based Baptist Health System, HealthTexas Medical Group and Aetna recently announced an accountable care collaboration and the introduction of the Aetna Whole Health^SM product in the San Antonio area.

Aetna Whole Health^SM is a collection of benefits plans that will provide Aetna members access to coordinated care from physicians and facilities in the Baptist Health System and the HealthTexas Medical Group. The plans are designed for employers with employees who live or work in several counties in Texas, including Bexar, Guadalupe, Comal and Kendall.

"It's a very exciting and new opportunity for both Baptist Health System and HealthTexas to work together and with Aetna," says Graham Reeve, president and CEO of Baptist Health System. Through the new collaboration, employers in San Antonio will have access to a network of physicians and facilities with "better price and better quality" moving forward, he adds.

Through the new accountable care organization, Baptist Health System and HealthTexas Medical Group will provide healthcare services to Aetna members through a combined five hospitals, 42 primary care offices and more than 900 physicians in the San Antonio area.

Through the collaboration, Baptist Health System and HealthTexas will transition from a fee-for-service model to a pay-for-performance model. Under the fee-for-service model, "the sicker the patient gets, the more physicians get financially, and that is misaligned," says Richard Reyna, MD, President of HealthTexas Medical Group of San Antonio.

Under the new arrangement, the goal is to set up a system that incentivizes everyone within our organizations to be on the same page and focused on keeping patients healthy, says Dr. Reyna. Baptist Health System and HealthTexas will be rewarded for meeting quality, efficiency and patient satisfaction measures. Quality measures that are care-driven and "relate to keeping a population healthy" will be used, adds Dr. Reyna.

Under the new model, patient, payer and provider incentives are aligned and that is extremely important, says Mike Nelson, market president of Aetna in south Texas.

"Through this accountable care arrangement, Aetna, Baptist Health System and HealthTexas are working together and have aligned incentives to bring to the market a better, lower cost and more coordinated care experience to our members," he adds.

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