Narrow Path Offered for Specialty Care


Aetna has seen the future and it is performance measurement. The insurer last month said it would expand a program that offers a network of specialists who have shown that they adhere to best-practice guidelines.

That program, called Aexcel, is for employers that use Aetna as third-party administrator. These companies have the option of offering their employees only Aexcel or Aexcel along with Aetna's larger network.

The program was launched this year in Dallas-Fort Worth, in Western Washington state, and in Northern Florida. On Jan. 1, 2005, Aexcel will be sold in six more markets: Atlanta, Houston, metropolitan D.C. (Maryland, Washington, D.C., and Northern Virginia), Los Angeles, Connecticut, and metropolitan New York/Northern New Jersey.

In addition to the geographical expansion, the health plan will increase the number of specialties beyond the initial six, which are cardiology, cardiothoracic surgery, gastroenterology, general surgery, OB/GYN, and orthopedics.

The additional six specialties are otolaryngology, neurology, neurosurgery, plastic surgery, vascular surgery, and urology.

One happy customer is Costco Wholesale, says Jay Tihinen, Costco's vice president for benefits and retirement plans. "Our employees have indicated that they are looking for information to help them differentiate health care providers. Aexcel helps us achieve these goals. We began offering Aexcel to our Seattle-based employees in January, and we are looking forward to introducing Aexcel ... in other parts of the country."

Specialists are included in the Aexcel network if they demonstrate good clinical performance and cost efficiency, something that drew a wary reaction from one physician association.

Mark S. Thompson, the executive director of the Fairfield County Medical Association in Connecticut, tells the Hartford Courant that while he can understand the desire to control rising health care costs, he's "not sure that creating a new network option of specialists is necessarily the best way to achieve those savings."

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

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