OCT
8, 2018
KEVIN SWEENEY Editor
ksweeney@nujournal.com
NEW ULM
— Tom Lindquist, CEO of the new Allina Health|Aetna Company, was in New Ulm
Wednesday to introduce the new partnership to potential customers for the
company’s plans.
Allina
Health|Aetna is the newest partnership for Aetna, which Lindquist said has
similar partnerships in five other cities in the U.S.
Allina
Health|Aetna is one of the state’s largest health care providers and one of the
nation’s biggest health insurance providers to offer a health plan that hopes
to provide better care options at a better cost. By partnering, Aetna and
Allina Health are able to focus on the individual with the common mission of
improving the individual’s health. The approach aligns the goals and mission of
each entity to focus on what’s best for the individual.
Lindquist
said one way to accomplish this is to get people focused on their own health,
which Allina has been doing for the past ten years with the Heart of New Ulm
program. By identifying people with health risks and helping them deal with
them before they become ill, people can avoid the illness and the costly
treatments that often come with them.
Allina
Health|Aetna is not in the individual market, so its customers would be businesses
and small groups looking for health insurance.
The
challenge for companies and groups looking for health insurance in the past is
to find a balance between the right benefits package and an affordable cost,
said Lindquist. In a joint venture like this, the health care provider and the
insurance company are not competing against each other, but are aligned in
their goals.
“For
us, as a joint venture, by aligning incentives, we can put forth a benefit
package at a price we think is going to be very competitive, because we are
actually working together,” Lindquist said.
Allina
Health|Aetna focuses on outcomes by having the clinicians serve as the primary
leader in care management. Instead of a registered nurse in the insurance
claims office running the health provider’s bill against some algorithm to see
if it is a normal, allowable claim, the health care providers have more input
on identifying people who need help “quicker, faster and
better,” said Lindquist. This cuts away administrative layers and
helps hold down costs.
Allina
Health|Aetna is also offering Medicare Advantage plans, which will be important
for the 300,000 or so Minnesotans who are losing their Medicare Cost plans due
to changes in government rules. Medicare Advantage plans provide supplements to
Medicare coverage to reduce out of pocket expenses for the patient.
NUMC
President Toby Freier pointed out that not all Medicare Advantage plans include
Allina Health and New Ulm Medical Center in their network of providers.
“It
will be very confusing and disappointing for seniors to learn Blue Cross
Medicare plans in the local area will not include NUMC in-network in 2019,” he
said.
Blue
Cross Blue Shield Minnesota will be offering Medicare Advantage PPO plans to
members in Blue Earth, Brown, Nicollet, Watonwan counties in 2019 which will
NOT include Allina Health and New Ulm Medical Center as in-network providers.
It
means patients would have significantly higher out of pocket expenses to
maintain a relationship with NUMC doctors and services starting Jan. 1, 2019.
Allina
Health will still be in-network for other Blue Cross commercial plans.
This
change will only affect the Medicare Advantage PPO plans.
Individuals
should talk with an insurance broker to find a plan that best meets their needs
and provides in-network access to their preferred physicians.
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