VIable

NDHI
NAT IONAL DIALOGUE FOR
Healthcare Innovation
Jointly-Owned Health Plan
Company with Aetna
Organization Overview
• Texas Health Resources is one of the largest faithbased,
nonprofit health systems in the United States,
which owns, operates, or otherwise affiliates with
25 acute-care and short-stay hospitals
• Texas Health had over 160,000 inpatient stays and
over 1.5 million outpatient encounters in 2015
• Aetna is a healthcare benefits company serving 46.5
million people nationally, and offering a range of
traditional and innovative health insurance products
and related services
Background
The shift in the American healthcare landscape toward
value-based care has resulted in increasing cost and
quality pressures, creating demand from employers
and consumers for new solutions to modernize the
healthcare system. In this new healthcare economy,
both Texas Health Resources and Aetna are committed
to developing value-based care models that improve
outcomes, lower costs, and enhance patient experience.
To this aim, Texas Health Resources and Aetna have
created a jointly-owned health plan company that will
focus on improving quality and affordability of care,
as well as enhancing the consumer experience. Both
partners will share equal accountability for the health
plan members, aligning incentives in order to reduce
unnecessary costs and improve quality of care.
Collaboration Details
The jointly owned health plan company will leverage
Aetna’s experience in health benefits administration
and Texas Health’s commitment to population health
management to achieve a shared goal: delivering
integrated, high-quality health care experience — from
health plan enrollment and hassle-free billing to preventive
care and state-of-the-art medical interventions
— at more than 350 access points across North Texas.
The collaboration drives forward Texas Health’s evolution
from an acute-care hospital system to a value-based
healthcare system, leveraging its recently
developed integrated care network: Southwestern
Health Resources. The joint venture also aligns with
Aetna’s goal of shifting 75% of its healthcare contracts
to value-based payment models by 2020.
As part of the joint venture, the partner companies are:
• Forming a physician-led network to manage care
coordination, which will feature Southwestern Health
Resources and offer:
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27 acute-care hospitals
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70 outpatient facilities
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350 community access points
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Over 500 physicians, through the Texas Health
Physicians Group
An Initiative of the
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Jointly-Owned Health Plan Company with Aetna