New Advanced Primary Health model combines trusted, interdisciplinary care team relationships with fixed-fee payment to achieve optimal health outcomes.
November 10, 2022 (Seattle, Wash. and San Clemente, Calif.) – Crossover Health announced today a new collaboration with Aetna, a CVS Health company, to bring needed innovation of health benefit design to Seattle-area employers and their employees. The collaboration grew from a shared vision to be at the forefront of meaningful healthcare change centered in better primary care access to achieve lower health care costs. This new plan benefit, Aetna Advanced Primary Health, will be available effective January 1, 2023. The new hybrid care model is integrated into a health plan, and pairs a trusted interdisciplinary care team with a fixed-fee, value-based payment model designed to achieve optimal health outcomes.
“As employers take more ownership of their total healthcare spend, this purpose-built benefit is intended to deliver on the promise of primary health – driving down costs while increasing care quality and improving health outcomes,” said Scott Shreeve, MD, Founder and CEO, Crossover Health. “The combination of our integrated care team and a fixed-fee payment model is a force multiplier for healthcare, and the first implementation of a Commercial Advantage plan in the market. We believe our success in the Seattle area will spur rapid expansion into other markets across the country.”
Aetna Advanced Primary Health provides an interdisciplinary care team which includes primary care, mental health, physical therapy, health coaching, and care navigators who refer into high-value secondary care services. Crossover’s hybrid care model includes nearsite health centers and a virtual care network which enables members to have choice in how they receive care – in person, virtually or via asynchronous messaging. The model is also novel for going beyond traditional “sick care” with its focus on prevention, social determinants of health, and proactive outreach that takes place via Crossover’s member technology platform, which makes possible continuous connectivity with members.
“Aetna Advanced Primary Health is a key part of our commitment to deliver high value health benefits to our plan sponsor partners,” explained Catherine Gaffigan, MD, President of Aetna’s Northwest-Mountain Market. “Our members will have exclusive virtual and in-person access to Crossover Health’s primary care, behavioral health, physical therapy, chiropractic care, and more as part of a comprehensive medical home. This offering will also provide access to the entire broad Aetna network and represents the type of innovation the market is demanding in the commercial insurance industry.”
In addition to the innovative care model, the benefit design is built on a value-based payment model. In contrast to fee-for-service payments that drive visit volume, this payment model is designed to drive optimal health outcomes. By simultaneously incentivizing both whole person care and total cost of care management, Aetna and Crossover are demonstrating a path forward for commercial payers to support true value-based care. This new plan benefit concept ensures employers can offer a competitive and differentiated benefit while making their health care cost structure competitive as well.
The pilot program, initially available to self-insured employers and plan sponsors with 51+ employees, will offer care at two Seattle metro Crossover Health Centers starting January 1, 2023. One location is in the central Westlake neighborhood at 1101 Dexter Ave N., and the other is across Lake Washington in the Eastside region of Bellevue at 188 106th Ave NE.
For more information, visit: crossoverhealth.com/for-health-plans/.
About Crossover Health
Crossover Health is the leader in delivering value-based hybrid care. The company’s national medical group delivers – at scale – Primary Health, a proven care model driven by an interdisciplinary team inclusive of primary care, physical medicine, mental health, health coaching and care navigation. With a focus on wellbeing and prevention that extends beyond traditional sick care, Crossover builds trusted relationships with its members and flexibly surrounds them with care – in-person, online, and anytime – based on the member preference. Combining a sophisticated approach to data analytics that incorporate social determinants of health, Crossover delivers concrete results and measurable value for employers, payers and most importantly, members. Together we are building health as it should be and engaging a community of members to live their best health. To learn more, visit crossoverhealth.com or follow us on social media @crossoverhealth.