Aetna Medicare CMO Outlines Aging-in-Place Agenda

America’s most significant wellbeing care corporations go on to aim on house-primarily based treatment and growing old in location as 2022 ways. That involves CVS Wellness Company (NYSE: CVS) subsidiary Aetna.

Between its property- and group-primarily based treatment initiatives, Aetna is doubling down on the use of telehealth and leaning into the CVS HealthHUB community, which provides seniors a selection of services, from preventative care all the way to acute treatment. The insurance company is likewise investing in “cost-helpful care administration programs” and growing its interactions with home-centric partners like Papa and Contessa Wellness, according to Dr. Jamie Sharp, main clinical officer for Aetna Medicare.

“We’re kind of assuming a new landscape for the supply of health and fitness care and moving absent from acute,” Sharp told House Well being Treatment News. “I assume it’s vital to emphasis on growing old in place.”

As of June 30, Aetna served about ​​9.8 million Medicare associates nationwide. Aetna Medicare’s overall footprint stretches throughout 46 states, with designs for dually qualified individuals available in in excess of two dozen states.

As CMO of Aetna Medicare, Sharp is tasked with increasing the care encounter and results for seniors. Alongside with her group, she in addition supports Aetna’s price-primarily based provider associations.

“We also have a genuine concentrate on driving well being fairness throughout the Medicare Gain (MA) room for our customers,” Sharp, an internal medicine health practitioner who expended her early career working in the hospital setting, reported.

A single of Aetna’s getting older-in-location initiatives is its Wholesome Getting older guidance program, which introduced about a calendar year ago. The interactive system is intended to help Aetna’s users with chronic disorders by supplying them applications to far better self-deal with their circumstances.

As section of the plan, users take part in a series of virtual classes, possibly as part of a team or on an person basis, Sharp stated.

“[Session] subjects could be about diet or it’s possible knowledge your remedies,” she reported. “It could be the influence of worry on your sickness approach or a range of different subjects. We’ve had actually constructive suggestions from our customers about this.”

Other residence-focused treatment administration initiatives contain its readmission avoidance plans. People are targeted on supplying superior-danger customers and their households “all the resources they need” to keep away from pricey re-hospitalizations.

“After they have an acute celebration and conclude up in a hospital, how do you transition them back again property, supporting them continue to be at house while getting back to their previous lifestyle?” Sharp said. “That may well be earning certain they have the foodstuff they have to have. Do they want transportation to pick up their medication? Have they built their abide by-up appointments with their companies and their experts?”

Aetna’s growing old-in-put agenda

CVS has designed turning much more of its suppliers into health care facilities a major precedence. Executing so helps make a good deal of perception for the business, which seeks to create more synergy in between its brick-and-mortar locations and its insurance policy arm.

HealthHubs perform a key job in that mission, and CVS expects to have 1,500 hubs in procedure by the finish of the year. As it invests in the community, it will concurrently near hundreds of suppliers that are not core to its wellness care system, CVS executives recently stated.

“We have HealthHubs spread across the United States,” Sharp said. “They’re right now redefining what products and services they are delivering, so they make sure they have a comprehensive plate of products and services to deliver to our seniors as a covered profit.”

Within each individual HealthHubs is a care counselor who can assist coordinate services for seniors, together with in-household treatment if it is required.

“That’s what those treatment counselors are about,” Sharp claimed. “They’re delivering that 1-on-one particular services for our members, knowledge what their needs are.”

Aetna’s getting older-in-spot agenda, in unique, features a marriage with Papa, the in-residence companionship startup that has raised additional than $240 million given that launching. Various other big insurers have equally struck partnership agreements with Papa, recognizing the value of addressing social determinants of health.

“Companionship aid, reducing that social isolation that is actually been current all through the pandemic is a reason we’ve expanded that marriage with Papa,” Sharp mentioned. “[We can] provide in those companions, make positive that they can meet up with with a member, just take them grocery searching, go on a stroll with them. Do that it’s possible 10 hrs a thirty day period, supplying customers the help they require so they can continue to be at house, keep secure.”

In the meantime, on the telehealth entrance, all Aetna MA programs will address telehealth for major care, urgent care, speciality treatment and psychological wellbeing in 2022. That protection is also aimed at enabling getting older-in-location.

“As the pandemic came up, we all understood that telehealth had to be a priority — and also promptly realized that seniors had been a lot more than eager to choose gain of it,” Sharp claimed. “We observed people statements go up, and we had been happy to see that they were capable to faucet into that chance.”

In addition to working with its HealthHub connections, masking telehealth and teaming up with Papa, Aetna is operating with revolutionary household-dependent treatment players these as Contessa Overall health, an Amedisys Inc. (Nasdaq: AMED) business.

Contessa has crafted its overall company all over shifting acute and complex treatment into the house, and that generates fascinating chances for Aetna, Sharp prompt.

“Nothing is off the guides,” she explained. “One of our JVs coming up for 2022 is with Contessa and Prisma Health in South Carolina for clinic at house. And I do not believe any of us were being contemplating about that, you know, five a long time back.”

Landmark Well being is one more Aetna residence-primarily based treatment partner.

“I feel health treatment is at a new time, the place we have to be inventive and have to set ahead all all those choices,” Sharp reported. “We have to break down obstacles of regular overall health care to make sure that our customers really don’t hold off treatment and that they can stay as healthier as possible in their home.”

Put up-acute treatment tendencies

When it arrives to write-up-acute treatment developments with Aetna’s MA customers, COVID-19 has been “a learning expertise,” Sharp reported.

Originally, Aetna members “froze,” with several not accessing care throughout the board, no matter whether the setting was a nursing home, in-individual rehab facility or some thing else.

“All of it just — growth, went down,” Sharp mentioned. “We however have not arrive back up to people pre-pandemic ranges.”

Submit-acute treatment utilization is commencing to creep back again up towards ordinary, aside from standard vacation dips. Whilst utilization of expert nursing services (SNFs) has been noticeably down, Aetna has not seen a corresponding uptick in home health utilization.

“​​We have not observed a product trend enhance in home wellbeing to offset that, which is form of intriguing,” Sharp claimed. “And I really do not know that I plainly have the answers for that.”