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Aetna Foundation Announces Grant to Drive Better Value in Health Care

"In our health care system, employers and taxpayers are the primary purchasers of health care services, and as health care costs continue to escalate, more and more purchasers are looking to understand how they can get real value from their health care investments," said Ronald A. Williams, chairman of the Aetna Foundation.

In payment arrangements based on value, providers of health care are held accountable for both the cost and quality of the care delivered - enabling them to receive more financial support for steps that improve care and lower costs, but that are not reimbursed in traditional provider payment systems. This is accomplished by examining both quality data, including patient outcomes and health status, as well as cost data. Participants in these arrangements manage the use of health care services to reduce inappropriate care and identify and reward the best-performing, high quality providers. Medicare, along with a number of employer-based insurers, is working to become a value-based purchaser of health care services. As an example, Medicare is testing payments for "medical home" services, and it initiated a program in 2008 to no longer pay hospitals for the cost of care associated with preventable hospital-based infections, mistakes, or injuries.

"This grant supports exploration into a range of effective approaches for implementing and evaluating value-based purchasing programs, as well as dissemination of the results of that work so that all health care purchasers - from private employers to the federal government - can take advantage of the learnings and conclusions," said Anne C. Beal, MD, MPH, president of the Aetna Foundation.

The $331,133 grant will support the "Advancing Value-Based Purchasing in the U.S. Health System" project, which will run through April 2011. The project will convene experts to recommend strategic approaches to value-based purchasing and share those recommendations with key stakeholders. The goal is to develop an implementation approach that will improve quality and reduce costs system-wide through the close collaboration of public- and private-sector stakeholders. As such, the project aligns with legislative mandates such as the creation of a Center for Medicare and Medicaid Innovation and supports efforts to rethink how to expedite the broad execution, evaluation, and dissemination of these value-based purchasing strategies in both the public and private sectors.

"The fragmentation and silos in our health care system complicate efforts to improve overall health system performance for patients. The new legislation provides unique opportunities for Medicare to participate in public-private collaborations in payment reforms that provide better support for high-value care, which will be critical to bending the cost curve and improving quality. We're pleased that the Aetna Foundation is supporting this effort to provide important insights at a pivotal time for health care reform implementation," said Mark McClellan, director of the Engelberg Center for Health Care Reform and Leonard D. Schaeffer Chair in Health Policy Studies at the Brookings Institution.

The value-based purchasing project is one of a number of initiatives underway at the Engelberg Center, which focuses on developing data-driven, practical policy solutions that promote broad access to high-quality, affordable, and innovative care in the United States. For more information about the Engelberg Center, visit www.brookings.edu/healthreform.

About the Aetna Foundation

The Aetna Foundation is the independent charitable and philanthropic arm of Aetna Inc. Since 1980, Aetna and the Aetna Foundation have contributed over $379 million in grants and sponsorships. As a national health foundation, we promote wellness, health, and access to high-quality health care for everyone. This work is enhanced by the time and commitment of Aetna employees, who have volunteered nearly 2 million hours since 2003. Our current giving is focused on addressing the rising rate of adult and childhood obesity in the U.S.; promoting racial and ethnic equity in health and health care; and advancing integrated health care. For more information, visit www.AetnaFoundation.org.

¹ Source: Organisation for Economic Co-operation and Development. OECD Health Data 2009 - Frequently Requested Data. http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.htm, Data accessed on 05/10/2010.

Aetna
Susan Millerick, 860-273-0536
millericks@aetna.com