Klein says Wisconsin employers who want to join the Aurora Accountable Care Network, which is being offered through Aetna beginning Jan. 1, 2013, must submit three years of data detailing the type of healthcare services they've purchased for their employees.
"The employer has to supply the data, the claims that they have historically experienced for three years and what we do is take a look at exactly what type of care and how much care was delivered in that period," Klein says. "We apply our own intelligence, using our own employees for the last 15 years. We look at the integrated value that Aurora brings and we put a guarantee on that, understanding that if we provide all the care we can be more efficient than the market in general."
"We have supplemented that with other national databases," he says. "This is the evolution from the healthcare system that historically has worked with employers on a single type of charge to much more longitudinal whole population management as it relates to their employee population."
The network plans are fully insured and feature two tiers of benefits and co-pays. They are designed for small and mid-sized businesses, and large, self-funded employer plans are also available. The savings are generated primarily through coordinated care for patients, lower co-pays with network providers, and better health outcomes.