Aetna Patient-Centered Medical Home Program - Connecticut

Program Location: 
Hartford, CT
Payer Type: 
Commercial
Partner Organizations: 
Connecticut State Medical Society Independent Practice Association
Payers: 
Aetna
Description: 

In 2012, Connecticut State Medical Society Independent Practice Association (CSMS-IPA) launched a collaborative care model designed to improve the quality of care for Aetna Medicare Advantage members and lower health care costs. More than 500 physicians affiliated with the CSMS-IPA throughout Hartford, New Haven, Fairfield, and Litchfield counties will be part of this Aetna Medicare Provider Collaboration program.

Through this program, Aetna nurse case managers work closely with physicians on quality and care management for eligible Aetna Medicare Advantage plan members. Aetna and the CSMS-IPA also work together to improve adherence to best practices and treatment plans and reward quality and efficiency measures in a number of different clinical areas. Aetna provides the CSMS-IPA with reports showing quality and efficiency measures at the individual member and population level.

Program Clinical Quality Metrics and Incentives:

  • Increasing percentage of plan members receiving annual office visits
  • Encouraging office visits every six months for members with chronic heart failure or diabetes
  • Encouraging blood glucose tests for members with diabetes
  • Confirming follow-up visits within 30 days of hospital discharge

Aetna will provide the CSMS-IPA with reports showing quality and efficiency measures at the individual member and population level.

Last updated February 2019
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