National health insurer Aetna and Texas Health Resources, a 27-hospital not-for-profit system based in Arlington, have agreed to jointly own and operate a new health plan designed to steer patients to specific providers.
Starting Jan. 1, 2017, Aetna and THR will offer the narrow network product in 14 counties around Dallas, where Aetna insures about 700,000 people. The plan will be available for fully insured and self-insured employers. Other terms were not disclosed.
Aetna's 50-50 business partnership with THR—in which Aetna will handle care management and claims analysis and the hospital system focuses on population health and actual care delivery—comes roughly four years after Aetna struck a similar deal with Inova, a health system based in Falls Church, Va.
The health plans provide incentives to keep patients within the health system's narrow network of hospitals and doctors, with the assumption the providers have higher quality marks and lower costs. Patients who have that kind of insurance but trek outside the network for care usually have to pay most or all of the care out of their pocket.
Anthem, the for-profit Blue Cross and Blue Shield competitor of Aetna, hatched a similar company with Aurora Health Care in Milwaukee last month. Hospital and health insurance executives said these kinds of joint ventures allow for more collaboration and patient-centered care.