Sutter Health | Aetna has announced its plans to offer fully insured products to employers across Northern California for the 2022 enrollment season. The announcement follows issuance of a Certificate of Authority from the California Department of Insurance (CDI), designating the joint venture healthcare company as an independent insurance carrier in the state.
- Eyes on Fully Insured Products: Sutter Health | Aetna currently offers self-insured Exclusive Provider Organization (EPO) and Preferred Provider Organization (PPO) commercial health plans to large employers in its 16-county service area. Today, if an employer wants a fully insured product, it must select an Aetna plan that includes the Sutter Health | Aetna performance network. Upon CDI approval, the joint venture will be able to sell its own fully insured products to employers, unlocking the full value of the Sutter Health | Aetna member experience.
- Integrated Delivery: The joint venture’s integrated delivery, retail, and financing system (IDRFS) model aims to revolutionize healthcare. Built on the strong foundations of its parent companies and further complemented by the capabilities of CVS Health, Sutter Health | Aetna’s IDRFS platform virtually integrates payer, provider, and retail stakeholders.
- Affordable Quality Care: Through coordinated and proactive care delivery, the platform is designed to offer the market high-quality care at an affordable cost. “The support and investment by Sutter Health and Aetna for the fully insured license further demonstrates the organizations’ commitment to the coordinated care model created by our virtually integrated delivery, retail, and finance system,” said Sutter Health | Aetna CEO Jeb Dunkelberger.
- Collective Commitment: Jeb Dunkelberger said that independent licensure for Sutter Health | Aetna supports the most progressive form of value-based care. This, he said, further demonstrates the organizations’ collective commitment to the clinical and financial experience of its members and underscores “our commitment to materially evolving the market via affordable, high-quality care and customized member experiences.”
- In Members’ Interests: Aetna’s Senior Vice President of Markets Kristen Miranda said that employers across the region should see the move as one of the strongest signals that Sutter Health | Aetna is fully aligned to their interests. “Through this fully insured licensure, the joint venture’s vision organically aligns to that of the member – accessible, affordable, innovative, and community-based.”