Introduction
Aetna®, a CVS Health® company has announced a significant expansion of its innovative Aetna Clinical Collaboration (ACC) program, scaling operations to ten hospitals by the end of the year. This groundbreaking initiative represents a transformative approach to post-hospital care coordination, specifically designed to support Medicare Advantage members during one of healthcare’s most vulnerable transitions: the journey from hospital to home.
The program is currently being implemented at three major healthcare systems: AdventHealth Shawnee Mission, Houston Methodist, and WakeMed Health & Hospitals. This strategic expansion marks a pivotal moment in value-based care delivery, bringing insurance providers and hospital systems together in an unprecedented collaborative model.
Understanding the Aetna Clinical Collaboration Program
What Makes ACC Different?
The Aetna Clinical Collaboration program introduces a revolutionary care coordination model that embeds Aetna nurses directly within hospital settings. Unlike traditional care management approaches where coordination happens remotely, ACC nurses work side-by-side with hospital staff, creating seamless communication channels and immediate access to member health information.
The On-Site Advantage
This physical presence within hospitals enables real-time care planning and immediate intervention when issues arise. Aetna nurses can participate in discharge planning meetings, consult with physicians and care teams, and establish relationships with patients before they leave the hospital. This proactive approach ensures continuity of care that extends beyond hospital walls.
The Hospital Readmission Challenge
Alarming Statistics
Hospital readmissions represent a critical challenge in American healthcare, particularly among elderly populations. According to industry data, nearly 20 percent of Medicare-insured patients who receive hospital care are readmitted within 30 days of discharge. These readmissions not only compromise patient health outcomes but also create significant financial burdens for healthcare systems and patients alike.
Why Readmissions Occur
Multiple factors contribute to high readmission rates, including:
- Inadequate discharge planning and patient education
- Poor medication management and understanding
- Lack of follow-up care coordination
- Social determinants of health, such as transportation challenges
- Limited support systems at home
- Complex medical conditions requiring specialized follow-up care
How the ACC Program Works
Integrated Care Teams
“Hospital discharge is one of the most important—and vulnerable—moments in a patient’s journey,” explained Dr. Ben Kornitzer, Senior Vice President and Aetna Chief Medical Officer. “Patients may be managing new diagnoses, complex medications, and follow-up needs, all while coping with the stress of transitioning back home or to a new facility.”
The ACC model addresses these challenges through comprehensive support services:
Care Coordination Services
Pre-Discharge Planning: Aetna nurses work with hospital teams to develop personalized discharge plans that address each member’s unique needs, including medication schedules, follow-up appointments, and home health services.
Medication Reconciliation: Ensuring patients understand their prescriptions, potential side effects, and proper administration techniques to prevent complications.
Post-Discharge Follow-Up: Continued support after hospital discharge, including telephone check-ins, home visits when appropriate, and coordination with primary care physicians.
Administrative Efficiency
Beyond direct patient care, the ACC program significantly reduces administrative burdens on hospital staff. By having Aetna representatives on-site, authorization processes become streamlined, reducing delays in care transitions and improving overall operational efficiency.
Expected Outcomes and Benefits
Measurable Impact
The ACC program has demonstrated impressive early results. The first implementation earlier this year achieved remarkable engagement, with approximately 1 in 4 program members actively working with an Aetna care manager. This high engagement rate indicates strong program acceptance and effectiveness.
Projected Improvements
Once fully implemented across all participating facilities, the ACC program is projected to deliver:
- Five percent reduction in year-over-year 30-day readmissions
- Five percent decrease in hospital length of stay
- Reduced emergency room visits for preventable complications
- Improved patient satisfaction and health outcomes
- Enhanced care team collaboration and communication
Current Implementation and Future Plans
Scale and Scope
As a leading Medicare Advantage health plan provider, Aetna serves more than 4 million members over age 65. This substantial membership base represents significant opportunities for impact through the ACC program expansion.
Beyond Medicare
Recognizing the program’s success with Medicare Advantage populations, Aetna is also implementing ACC for its Commercial business. This expansion demonstrates the company’s commitment to innovative care delivery models across all member segments.
2026 and Beyond
Aetna plans to continue expanding the Clinical Collaboration program throughout its hospital network in 2026 and subsequent years. This long-term commitment signals confidence in the model’s effectiveness and scalability. The company aims to partner with hospitals nationwide, creating a comprehensive network of collaborative care sites that prioritize patient outcomes and experience.
Conclusion
The Aetna Clinical Collaboration program represents a fundamental shift in how health insurance companies and healthcare providers work together. By embedding care coordinators directly in hospital settings, Aetna is addressing one of healthcare’s most persistent challenges: ensuring safe, successful transitions from hospital to home. As the program expands to ten hospitals by year-end and continues growing into 2026, it promises to improve outcomes for thousands of Medicare Advantage members while demonstrating the power of true healthcare collaboration.
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