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Aetna Offers Atlanta Employers Self-Insured Plans

The Aetna Whole Health plan aims to provide employers fully-insured and self-insured plan options with ACOs and upside risk contracts.

Aetna Whole Health plans to offer employers access to self-insured and fully-insured plan options that focus on better care coordination through accountable care organizations (ACOs) and incorporating upside risk value-based contracting.

Aetna Whole Health partners with accountable care organizations—in this case, Emory Healthcare and Northside Hospital System—with the aim of offering low-cost, high-quality, value-based care.

The model is upside risk for the 900 primary doctors, 3500 specialists, 14 hospitals and over 500 outpatient facilities with which Aetna now partners in Atlanta.

Each patient has a care management program to improve patient outcomes. These care teams enable greater care coordination for individual patients.

All 16 Atlanta CVS HealthHUBs will be included in this new model, as well as the 15 to 20 new HealthHUBs that the company intends to establish in 2020.

Whole Health plans, which orbit around accountable care organizations and strong care coordination, may especially appeal to self-insured employers, who are increasingly becoming employer activists.

These employer activists are relying on accountable care organizations, according to Steve Wojcik, vice president of public policy at the National Business Group on Health. They also rely on centers of excellence and high-performance networks to drive forward positive patient outcomes for their employees.

As Aetna changes its options for fully insured or self-insured employers, private payer giants are revolutionizing the rest of Georgia’s healthcare system as well.

Aetna Whole Health has been active for several years, with Whole Health plans available to employers in Virginia as early as 2012.

Previous Aetna Whole Health plans included the Orlando Health and UnityPoint 2018 partnership in Florida. Like the new plan starting in Atlanta, these agreements were with accountable care organizations and were projected to save employers 15 percent on their overall healthcare spending.

Also an upside risk agreement, the plan outlined four main quality measures which Aetna tracked to determine the accountable care organizations’ rewards:

  • Patient satisfaction scores
  • Preventive screenings
  • Hospital admissions
  • Chronic care management

The partnership goes into effect on April 1, 2020.

4 trends for healthcare 2019

4 Trends in Healthcare for 2019

Healthcare can be confusing, especially when trends change rapidly with advancements in science and technology and government regulations.

Value-Based Care:

In a value-based system, providers, hospitals, and physicians are paid based on their patient’s health outcomes, rather than how many patients they see or how many hours they log. Health outcomes are measured in factors such as improvement in overall health, reduced diagnoses of chronic diseases and the ability to live independently at home.

The Aging Wave:

The Census Bureau projects that in 2034, for the first time, people 65 and older will outnumber those under 18. Additionally, Medicare enrollment is expected to increase by nearly 50 percent, rising from 54 million today to more than 80 million in 2030. This aging wave creates multiple ripples, starting with the healthcare needs of seniors who are increasingly living with one or more chronic condition that requires long-term care in a healthcare facility or at home. It also impacts spouses or adult children who take on the often-full-time role of providing or coordinating care, which can leave them facing caregiver burnout as they continue to work or raise their children.

Silver Structure:

We’ve been hearing about designing green for years to make sure facilities are energy efficient and cost-effective. However, adults over the age of 74 had the highest rate of hospital stays in 2014, followed by people in their late 60s and early 70s, so it makes a great deal of sense to shift to what is being referred to as “silver architecture.” These designs help improve quality of life and independence for an aging population and are well-lit, quiet, accessible and safe to navigate for assistive devices like wheelchairs and walkers.

Patients Engaging:

Studies show that people who are more involved in decisions about their care plan see better health outcomes. However, these people are generally more satisfied with their care as well, which can be a significant advantage to healthcare providers who rely on online reviews to inform potential patients and families to choose care with them. In 2019, expect to see more engagement programs, apps and technology, and health literacy initiatives that aim to educate people on their condition and care.

five personal skills you need in healthcare

Skills You Need To Succeed In A Healthcare Career

When planning your career growth in healthcare, you’ve likely considered the best education options. The skill set you learn to work as a physician, nurse, or any type of support staff in healthcare is understandably a high priority.

We often spend so much time considering the type of training and level of references we need to advance, that we don’t consider the soft skills that are also important for a long-lasting career. Whether you work in a small practice or a large hospital, there are high stakes involved in your day to day responsibilities. Healthcare workers can deal with long schedules and a much more stressful work environment than other types of professionals.

Developing the personal skills necessary to succeed in the field will not only make you a better employee but will help you find a balance between your work and personal life.

5 Personal Skills You Need in Healthcare

The technical skills you need to succeed in your position are only part of the equation. These five personal skills are essential to your continued career growth in healthcare:

  1. Empathy. Of course, empathy will help your interpersonal skills, regardless of your profession. In healthcare, though, you’re often dealing with people at their most vulnerable. Because you see a wide range of health issues, it can sometimes be hard to remember to put yourself in the patient’s shoes. When they’re concerned over what you know to be a moderate illness, you might be tempted to overlook their worries. To give your patients the best tools and experience possible, always try to remember that they don’t have the healthcare background that you do. Try to remember how scary and frustrating it can be to not have control of your health issues. Empathy will also serve you well in dealing with coworkers and other staff members. Healthcare is very much a team environment. Understanding goes a long way to developing good relationships.
  2. Communication Skills. Communication is essential in dealing with the different facets of your position. It’s important that you’re clear in any notes or written communications, especially when they deal with the treatment of a patient. It also serves you well to be able to speak with patients and coworkers in a clear and pleasant manner to avoid misunderstandings and help facilitate a productive environment.
  3. Dedication and Work Ethic. In other industries, workers often have fixed hours with set breaks and lunchtimes. They are asked in advance if they’d like to work overtime and can plan on leaving their job at a set time every day. Healthcare workers, however, often forego lunch and breaks and will sometimes work exceptionally long hours with little notice. Most healthcare workers love what they do and are dedicated to each patient and case that they see during their day.
  4. The Ability to Deal with High-Pressure Situations. Mistakes in healthcare can have extremely high consequences. Outcomes aren’t guaranteed even when you follow the best practices for a give situation. This makes for a very high-pressure situation which can be exacerbated by outside influences, such as family and the patient. Many people who do well in healthcare careers thrive on the high stake’s nature of the job. They do well under pressure and can make split-second decisions without second-guessing themselves.
  5. Life Long Learning. The phrase, “there’s nothing new under the sun” does not apply in healthcare. There are always new techniques and procedures available. Even in specialties that don’t see a lot of change, you have to be able to adapt to other physician’s processes and to be able to take critique well. The focus is on providing the best possible care. A good healthcare professional leaves their ego at the door and embraces every opportunity to learn new skills.

Whether you’ve been in the industry for many years or are just starting out, improving these five soft skills will help you build a longer, more successful career in your field.