Crossover Health is buddying up with Aetna, a CVS Health company, to launch a new advanced primary health model that bundles Crossover’s signature in-person-and-virtual primary care, mental health, physical therapy, health coaching, and care navigation offering – and its fixed-fee, value-based payment model –as a new plan option for Aetna’s employer client base.
The new primary health model, called Aetna Advanced Primary Health, is first rolling out in the Seattle-area in January 2023 and Aetna’s President for Arizona & Northwest Mountain Markets Catherine Gaffigan and Crossover Health’s CEO Scott Shreeve are here to talk about why this new model is truly an innovation in benefit design for employers.
Crossover, and others like it, have sold their brand of high-touch, value-based primary care direct-to-employers for years, but the same kind of offering has rarely been baked into a total benefit design along with other elements of a health plan and offered commercially. Scott’s designating it a ‘Commercial Advantage’ plan (riffing off similarly designed Medicare Advantage plans) and it could mean BIG things for scaling value-based care models and for a shift in how carriers and employers view spending on primary care.
“People think of primary care as a loss leader,” explains Scott. “What we want to do is flip the narrative and turn this into the winning catalyst to really drive on cost savings.”
Aetna’s actuaries crunched the numbers and Catherine summarizes the potential they see, “If you can find that right balance of primary care versus specialty care, you really can reduce total cost of care – and that's what we're going for here. Essentially, we want to pay more for primary care – or, I'll call it primary health because I want to talk about that holistically – and that should actually, in fact, reduce our total cost of care.”
Improving affordability for employers and their employees is only part of the story. We get into what this means for consumers, the rise of “local health,” and what both Aetna and Crossover will be tracking as Aetna Advanced Primary Health rolls out with its new sponsors and consumers in January.
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