Texas Health, Aetna create jointly owned health plan company

Texas Health Resources and Aetna today announced the creation of a jointly owned health plan company.

The partnership between Aetna and Texas Health is the first of its kind in North Texas to fully align the incentives and capabilities of a national insurer and major health system, according to a news release from the two organizations.

“Over the past several years, the American health care landscape has begun to change, with increasing costs and quality pressures creating demand from employers and consumers for a new health care economy,” said Barclay E. Berdan, CEO of Arlington-based Texas Health Resources. “This partnership aligns our two organizations’ commitment to build more sustainable value-based models of care, which will help to deliver better outcomes and lower costs, while providing an unmatched patient and provider experience. It’s what consumers expect of us in this new economy and, frankly, what we expect of ourselves.”

New fully-insured and self-insured commercial products will be offered to employers and consumers in 14 counties in the Dallas-Fort Worth area, including Collin, Cooke, Dallas, Denton, Ellis, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Somervell, Tarrant and Wise counties. The new insurance products should be available on first day of 2017, pending regulatory approval. Marketing of the new products will begin in the fall, according to Aetna and THR officials.

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The jointly owned health plan company will have its own board and management and its own name, which has yet to be chosen, officials with Aetna and THR said.

The new partnership will feature the Southwestern Health Resources network as its core, which includes more than 500 physicians in Texas Health’s employed physician group, Texas Health Physicians Group (THPG). Texas Health’s 69 outpatient facilities include surgery centers, fitness centers, imaging centers and more than 250 other community access points. Its hospitals include 16 acute-care facilities, along with six short-stay, one transitional care and two rehabilitation hospitals.

By sharing ownership and accountability equally, the new health plan will focus on the consumer experience by combining fully integrated care teams, health insurance benefits and administrative services to eliminate redundancies of care and to reduce administrative hassles.

“Our joint venture with Texas Health represents two leading health care organizations coming together to fundamentally improve and streamline the health care experience for individuals and employers in the Dallas-Fort Worth Metroplex,” said Gary Loveman, executive vice president of Aetna and president of Consumer Health and Services. “We will drive a focus on better health and wellness through coordinated care, proactive outreach and evidence-based clinical approaches for members.”

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THR and Aetna have already worked together on an accountable care organization (ACO) that the two formed in 2013.