Aetna, Crossover Health launch pilot primary care program
The primary care market is heating up even more with Aetna Advanced Primary Health, which will offer zero cost share for health plan members - and eventually expand to other markets.
Aetna, a CVS Health company, is teaming up with Crossover Health to provide access to primary care to employer-sponsored health plans in Seattle.
Aetna Advanced Primary Health will be available effective January 1, 2023. The pilot program, initially available to self-insured employers and plan sponsors with more than 51 employees, will offer care at two Seattle-metro Crossover Health Centers. Aetna and Crossover plan to eventually expand the model to other markets,
“This is a relationship that’s value-based, first and foremost, with a focus on removing barriers to accessing health care,” Catherine Gaffigan, M.D., president of Aetna’s Northwest-Mountain Market, told Fierce Healthcare.
Under the fixed-fee payment model, Crossover will be responsible for the total cost of care, with zero cost share for health plan members for both in-person and virtual doctor visits.
“Aetna is excited to bring something innovative like this to the market,” she said, “and it’s innovative in different ways to other value-based care arrangements. It’s the next step in that innovation. We’re also addressing the cost issue from the member perspective through a zero-dollar benefit, and that’s extremely important as we figure out how to enable our members to engage in this health-care system. Crossover also delivers an extraordinary consumer experience.”
The collaboration with Aetna enables Crossover Health to “go deep” with a health plan partner, says Scott Shreeve, M.D., Crossover Health founder and CEO. “Aetna brings expertise and a lot of different capabilities and assets to this partnership, such as data intelligence and care programming, so we can create an integrated, seamless offering,” he said. “We can do things in combination that neither of us could do before.
“As employers take more ownership of their total healthcare spend, this purpose-built benefit is intended to deliver on the promise of primary health – driving down costs while increasing care quality and improving health outcomes,” said Shreeve. “The combination of our integrated care team and a fixed-fee payment model is a force multiplier for healthcare, and the first implementation of a Commercial Advantage plan in the market. We believe our success in the Seattle area will spur rapid expansion into other markets across the country.”
Drugstore retail giant CVS Health owns Aetna, having acquired the insurer in 2018 in a $69 billion deal. The primary care market has been heating up as retailers make strategic moves to push further into health care. Amazon plans to buy One Medical for $3.9 billion, and Walgreens-backed VillageMD is buying Summit Health, owner of CityMD, for $8.9 billion.
CEO Karen Lynch of CVS Health told analysts in an earnings call earlier this year that CVS planned to make a big move in primary care by investing or acquiring a provider by the end of this year. In September, the company won a bidding war for Signify Health, a home health and technology services company, as a major step in its health-care service strategy. CVS plans to acquire Signify Health in a deal valued at $8 billion.