Aetna Medicare CMO Outlines Aging-in-Place Agenda

Linda Rider

America’s greatest wellness treatment organizations proceed to aim on property-dependent care and growing older in location as 2022 strategies. That consists of CVS Wellbeing Corporation (NYSE: CVS) subsidiary Aetna.

Among the its property- and group-based treatment initiatives, Aetna is doubling down on the use of telehealth and leaning into the CVS HealthHUB network, which presents seniors a range of products and services, from preventative care all the way to acute treatment. The insurance provider is furthermore investing in “cost-powerful care administration programs” and increasing its associations with property-centric associates like Papa and Contessa Well being, in accordance to Dr. Jamie Sharp, main clinical officer for Aetna Medicare.

“We’re variety of assuming a new landscape for the delivery of overall health care and going away from acute,” Sharp advised Residence Health Care News. “I feel it is essential to concentrate on aging in put.”

As of June 30, Aetna served about ​​9.8 million Medicare customers nationwide. Aetna Medicare’s overall footprint stretches across 46 states, with ideas for dually eligible persons obtainable in more than two dozen states.

As CMO of Aetna Medicare, Sharp is tasked with improving the care knowledge and outcomes for seniors. Alongside with her group, she moreover supports Aetna’s worth-centered service provider interactions.

“We also have a serious target on driving wellbeing fairness across the Medicare Benefit (MA) place for our associates,” Sharp, an interior drugs medical professional who used her early job functioning in the hospital environment, reported.

Just one of Aetna’s ageing-in-put initiatives is its Healthier Getting old guidance software, which launched in excess of a yr back. The interactive program is made to assist Aetna’s associates with long-term disorders by giving them applications to greater self-regulate their problems.

As component of the software, associates participate in a series of digital classes, both as component of a group or on an unique foundation, Sharp discussed.

“[Session] subjects could be about nutrition or it’s possible comprehension your prescription drugs,” she explained. “It could be the impression of anxiety on your illness approach or a wide range of diverse subject areas. We’ve experienced definitely good responses from our associates about this.”

Other residence-focused care administration initiatives contain its readmission prevention applications. Those people are centered on giving higher-possibility members and their people “all the means they need” to keep away from high-priced re-hospitalizations.

“After they have an acute occasion and end up in a clinic, how do you transition them again home, assisting them keep at home though finding again to their previous everyday living?” Sharp explained. “That may possibly be producing absolutely sure they have the foods they want. Do they have to have transportation to decide up their medication? Have they made their comply with-up appointments with their vendors and their professionals?”

Aetna’s getting old-in-put agenda

CVS has built turning more of its stores into wellness treatment facilities a severe precedence. Undertaking so tends to make a lot of feeling for the enterprise, which seeks to develop far more synergy concerning its brick-and-mortar destinations and its insurance policies arm.

HealthHubs perform a big part in that mission, and CVS expects to have 1,500 hubs in operation by the stop of the calendar year. As it invests in the community, it will at the same time close hundreds of merchants that aren’t main to its well being treatment strategy, CVS executives recently stated.

“We have HealthHubs distribute across the United States,” Sharp stated. “They’re proper now redefining what services they’re providing, so they make sure they have a comprehensive plate of products and services to supply to our seniors as a covered benefit.”

Inside of each HealthHubs is a treatment counselor who can help coordinate companies for seniors, including in-dwelling care if it’s essential.

“That’s what people care counselors are about,” Sharp claimed. “They’re offering that 1-on-one provider for our associates, being familiar with what their demands are.”

Aetna’s growing older-in-area agenda, in individual, features a marriage with Papa, the in-property companionship startup that has raised a lot more than $240 million because launching. Numerous other significant insurers have similarly struck partnership agreements with Papa, recognizing the worth of addressing social determinants of wellness.

“Companionship aid, reducing that social isolation which is truly been current through the pandemic is a explanation we have expanded that connection with Papa,” Sharp said. “[We can] carry in these companions, make sure that they can meet up with with a member, just take them grocery purchasing, go on a wander with them. Do that possibly 10 several hours a thirty day period, giving members the assistance they have to have so they can remain at residence, keep risk-free.”

Meanwhile, on the telehealth entrance, all Aetna MA options will protect telehealth for principal care, urgent care, speciality care and psychological wellbeing in 2022. That coverage is also aimed at enabling aging-in-put.

“As the pandemic arrived up, we all recognized that telehealth had to be a priority — and also swiftly recognized that seniors had been a lot more than prepared to consider advantage of it,” Sharp said. “We observed these promises go up, and we were being satisfied to see that they were able to tap into that chance.”

In addition to making use of its HealthHub connections, masking telehealth and teaming up with Papa, Aetna is performing with modern dwelling-based care players this kind of as Contessa Overall health, an Amedisys Inc. (Nasdaq: AMED) firm.

Contessa has created its entire small business all around shifting acute and intricate treatment into the dwelling, and that makes remarkable options for Aetna, Sharp advised.

“Nothing is off the books,” she claimed. “One of our JVs coming up for 2022 is with Contessa and Prisma Wellbeing in South Carolina for hospital at residence. And I never imagine any of us were being imagining about that, you know, 5 many years in the past.”

Landmark Health is a different Aetna residence-dependent treatment lover.

“I think wellbeing care is at a new time, where by we have to be inventive and have to set forward all those selections,” Sharp said. “We have to split down barriers of traditional wellbeing care to make sure that our members really don’t delay care and that they can remain as wholesome as possible in their dwelling.”

Put up-acute care tendencies

When it arrives to publish-acute treatment tendencies with Aetna’s MA users, COVID-19 has been “a finding out knowledge,” Sharp stated.

Originally, Aetna members “froze,” with a lot of not accessing care across the board, no matter if the environment was a nursing household, in-patient rehab facility or something else.

“All of it just — boom, went down,” Sharp explained. “We even now have not appear again up to these pre-pandemic amounts.”

Article-acute care utilization is commencing to creep back up towards standard, apart from typical holiday getaway dips. Whilst utilization of competent nursing services (SNFs) has been noticeably down, Aetna has not observed a corresponding uptick in property overall health utilization.

“​​We have not found a substance pattern improve in home health and fitness to offset that, which is kind of intriguing,” Sharp reported. “And I really don’t know that I evidently have the solutions for that.”

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