Aetna, Hartford, Conn., will steer patients to specialists meeting certain standards of care under a new program called Aexcel. The insurer will launch the tiered physician network in Dallas/Fort Worth, North Florida and the Seattle area by January 2004 and expand the concept into additional markets over the next two years. Officials said Aexcel will consist of doctors in six specialties that account for a large share of healthcare spending -- cardiology, cardiothoracic surgery, gastroenterology, general surgery, obstetrics/gynecology and orthopedics. Participating doctors were chosen based on cost-efficiency, outcomes, number of procedures and rate of adverse events. Members will get incentives, typically lower copayments, to visit specialists in the network. Aetna's effort is part of a trend among health insurers to divide hospital and physician networks into tiers based on how providers rank in terms of quality and cost-efficiency measures. The goal is to encourage healthcare consumers to make more cost-conscious choices and to regain some of the negotiating leverage lost to providers in recent years. -- by Laura B. Benko
Aetna to steer patients to certain specialists
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