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Health care group tries new approach

Goal is lower costs, improved outcomes

Bridges Health Partners, a Cranberry-area health care consortium, has partnered with Aetna to provide an outcome-based approach to health care for individuals covered through Aetna’s commercial employer-provided insurance.

Bridges, based in Marshall Township, was formed three years ago by certain affiliates of Butler Health System, Excela Health System, St. Clair Hospital and Washington Health System, and represents all independent and employed medical providers of those systems.

As such, more than 1,000 physicians at those four hospital systems will partake in the approach, called a value-based agreement.

A value-based agreement provides the health networks with reimbursement based on patient outcomes, rather than the typical fee-for-service model that charges based on each procedure performed. Bridges has entered into similar agreements with Aetna’s Medicare Advantage program, Cigna’s commercial members and Humana Medicare Advantage members.

The company called the value-based approach a way to both improve health outcomes and decrease the cost of health care provided by the four affiliated systems.

“Working collaboratively, Bridges and Aetna will use insights derived from clinical, claims and administrative data to promote a healthier workforce through wellness promotion and early intervention,” Dr. Robert Zimmerman, Bridges’ chief medical officer, said in an Aug. 25 statement. “The relationship will optimize our ability to create evidence-based clinical pathways to provide high quality, cost effective care as well as ensure a seamless patient experience across the healthcare continuum.”

Zimmerman said the previous Medicaid Advantage agreement had a positive effect, and called the new agreement with Aetna’s commercial program a “natural extension” of those outcomes.

“Working together, we’ve been successful in achieving and delivering excellent clinical outcomes and value for the communities we serve,” he said.

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