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    Opinion: Four reasons Texas Health Aetna joint venture is working

    In 2018, PwC’s Health Research Institute predicts the cost of healthcare will rise by 6.5%, meaning the spending continues to outpace the economy. In Texas specifically, healthcare costs increase approximately 6% each year, according to CMS

    Unfortunately, these rising costs do not equate to a higher of quality care, with many people across the country complaining about our nation’s healthcare industry. In fact, North Texas ranks significantly low on many healthcare quality, outcome and satisfaction measures. This problem stems from uncoordinated efforts and unaligned incentives between insurance companies, providers, pharmacies, labs and most other health facilities.

    To diminish and eventually eliminate these issues, Texas Health Resources and Aetna came together to create the first joint venture of its kind in the North Texas market—Texas Health Aetna. Our goal is to transform the healthcare experience for employers, providers and members, removing the roadblocks and streamlining processes to create a better experience. We are working to break the traditional care model by offering our members four differentiating values.

    Seamless integrated experience

    Did you know the average physician appointment wait time is 15 days or more? In today’s fast-paced world, this is simply unacceptable. If your child comes down with the flu, the options currently available are to visit an urgent care center or the emergency room, as there is a good chance the pediatrician will not be able to see them immediately. Texas Health Aetna members are offered next day or same day appointments with primary care physicians who have opted into our plan and provide high-quality care and an improved, simplified experience.

    Additionally, physician office and emergency department visits have increased by 18% and 21% respectively. Sometimes a trip to the doctor isn’t necessary, but we still want an expert’s opinion. Therefore, we created the Texas Health Aetna ER Doc app to give members 24/7 virtual care access at their fingertips for nonemergency situations. If a member has a question about a rash or a cough, they can consult a board-certified ER physician to determine next steps. This allows members to have peace-of-mind knowing they have a physician available to answer questions, free of charge, any time of the day or night.

    Healthcare is personal and the level of care members receive should also be personal. Each member who signs up receives a customized onboarding and welcome packet and access to a navigation center where they can speak with local nurses and customer service representatives. No longer do they have to talk with someone who doesn’t understand the market landscape of North Texas, but instead can talk to a neighbor down the street.

    Next: Analytics-driven engagement

     

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