Aetna, a CVS Health Inc. (NYSE:CVS) company, announced it will scale the Aetna Clinical Collaboration (ACC) program to ten hospitals by year-end, with implementations underway with AdventHealth Shawnee Mission, Houston Methodist, and WakeMed Health & Hospitals.
The ACC program brings Aetna nurses together with hospital staff to help Medicare Advantage members.
Hospital readmissions happen more often among older populations, with nearly 20% of Medicare-insured patients who are hospitalized being readmitted within 30 days of being discharged.
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The ACC program aims to improve care outcomes for Aetna Medicare Advantage members, reducing their 30-day readmission rates and emergency room visits while also easing the administrative load on hospitals and clinical personnel.
“Hospital discharge is one the most important, and vulnerable, moments in a patient’s journey,” said Dr. Ben Kornitzer, Senior Vice President and Aetna Chief Medical Officer.
The first ACC program was implemented earlier this year, with approximately 1 in 4 program members already actively engaged with an Aetna care manager.
Once fully implemented at scale, the ACC program is projected to reduce year-over-year 30-day readmissions and hospital length of stay by 5%.
Aetna has more than 4 million members over 65 and plans to continue expanding the ACC program across its network in 2026 and beyond.
The company is also implementing ACC for its Commercial business.
CVS Health’s move follows a July rule from the Centers for Medicare & Medicaid Services that will count Medicare Advantage members in hospital readmission penalty calculations starting in fiscal 2027.
Reuters reported that the American Hospital Association has opposed the change, arguing it unfairly punishes hospitals for outcomes tied to coverage delays and denials.
The Centers for Medicare & Medicaid Services reviews hospital performance annually, cutting payments by up to 3% for facilities with higher-than-expected 30-day readmissions.
In fiscal 2023, three-quarters of eligible hospitals were penalized, per Advisory Board data.
A CVS spokesperson told Reuters that the program aims to improve patient outcomes, ultimately benefiting Aetna and providers, and noted the company intends to back similar initiatives in the future.
Price Action: CVS stock is trading higher by 0.36% to $75.19 at last check Monday.
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