Three Southern California health systems — San Diego-based Sharp HealthCare, Mountain Valley-based MemorialCare and Renton, Wash.-based Providence Health and Services' Los Angeles County facilities — introduced a regional health plan with Aetna Aug. 13.
The plan, which includes PrimeCare Physicians group in Bakersfield, Calif., is dubbed Aetna Whole Health-Southern California. The policy will give members in-network access to 51 hospitals, 122 urgent care facilities, and about 1,400 primary care physicians and 8,300 specialists. The new plan is available for self-insured employers and will be available for fully insured employers pending regulatory approval. Aetna's separate plans with each organization will still be available for employers.
Under Aetna Whole Health-Southern California, providers' reimbursement agreements will be tied to quality and care costs. The new payment model will reward providers for meeting quality and patient satisfaction measures, including preventive care, chronic care management, hospital readmission rates and emergency room visits.
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