Message #89 From:
NewsBot Date: January 17, 2007 05:00:00 AM
AET News AFL-CIO Employer Purchasing Coalition (AEPC) Endorses Aetna PPO and Joint Claim Administration Offerings
SOUTHFIELD, Mich.--(BUSINESS WIRE)--The AFL-CIO Employer Purchasing Coalition (AEPC) announced today that it
is endorsing Aetna (NYSE:AET) as its transparency vendor of choice,
selecting the Aetna preferred provider organization (PPO) health plan,
as well as Aetna Joint Claim Administration™
for AEPC members. AEPC also selected PPOM, an Aetna member company, for
its health network lease offering. AEPC is a not-for-profit corporation
that assists organized labor in the group purchasing of health care
services for 25 member organizations. AEPC member organizations together
cover more than 200,000 lives.
Phillip Schloop, business manager for the International Union of
Operating Engineers Local 547 and president of AEPC’s
board, said, “AEPC’s
decision to select Aetna as its transparency vendor of choice was based
on Aetna’s demonstrated commitment to
transparency of cost and quality data. With access to this type of
information, our member organizations can make knowledgeable decisions
when selecting the health benefits package that best serves their
members and families.”
“We are excited about the trust organized
labor has placed in us,” said Deborah
Lantzy-Talpos, Aetna’s market head in
Michigan. “If we can get members engaged in
exploring new ways to achieve optimal health, we will have made a real
contribution to their lives, and to the health and productivity of
our Michigan communities.”
Aetna’s Open Choice PPO®
offers members access to Aetna’s nationwide
network of more than 767,000 health care professionals and 4,467
hospitals. AEPC member organizations that prefer to handle their own
member services directly or through a third-party administrator can
select Aetna Joint Claim Administration™.
Through this new offering, AEPC member organizations and their
third-party administrator or trust fund office handle all member
services, including benefit determinations, with Aetna handling claim
payment, medical management and provider reimbursement. For AEPC member
organizations interested in leasing an independent network of
physicians, hospitals and other health care providers, PPOM provides a
six-state network of more than 70,000 health care professionals and 480
hospitals.
“Aetna’s online
member tools are impressive,” said Suzanne
Paranjpe, Ph.D., executive director of AEPC. “In
addition to gaining online access to physician-specific information on
clinical quality and efficiency, members will benefit from Aetna’s
medical management strategy, Aetna Health ConnectionsSM,
which uses the CareEngine®
System to help improve health care quality and patient safety.”
The CareEngine®
System is a proprietary technology developed by ActiveHealth
Management, another standalone business of Aetna’s.
“The CareEngine automatically
integrates detailed, claims-driven information gathered across the
health care spectrum – physician office
visits, labs, diagnostic treatments and prescriptions –
and compares this information against highly respected sources of
medical literature,” explained Stuart
MacDonald, Aetna’s vice president for the
Labor Division in the North Central Region who will be working directly
with the AEPC membership. “If the system
identifies an issue, it alerts individuals and their physicians about
possible opportunities to improve care. To date, the CareEngine
has found more than 1.8 million opportunities to improve the quality of
health care Aetna members receive with over 830,000 opportunities
uncovered in 2006 alone.”
About AEPC
AEPC is a not-for-profit corporation that was established in 1993 to
assist organized labor in the group purchasing of health care services.
AEPC has highly successful value-based purchasing programs for pharmacy,
dental, vision, and disease management services. Today, AEPC members
include 25 organizations’ health benefit
plans covering more than 200,000 lives.
About PPOM
PPOM is a regional preferred provider organization (PPO) based in
Southfield, Michigan. PPOM links insurers and their clients with a
six-state network of more than 480 hospitals and 70,000 physicians and
other health care providers. Coverage extends across all of Michigan,
Ohio, Indiana, and into parts of Illinois, Wisconsin and Kentucky.
Nearly one million individuals have access to the PPOM network. In 2005,
PPOM and other HMS Healthcare, Inc. companies were acquired by Aetna
Inc. as part of a strategy to offer provider networks, selected medical
management services and health care specialty services to customers
outside Aetna’s core distribution channels.
For more information on the PPOM network visit: www.ppom.com.
About Aetna
Aetna is one of the nation’s leading
diversified health care benefits companies, serving approximately 29.8
million people with information and resources to help them make better
informed decisions about their health care. Aetna offers a broad range
of traditional and consumer-directed health insurance products and
related services, including medical, pharmacy, dental, behavioral
health, group life, long-term care and disability plans, and medical
management capabilities. Our customers include employer groups,
individuals, college students, part-time and hourly workers, health
plans and government-sponsored plans. www.aetna.com
