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Aetna's Compassionate Care Program: Sustained Value for Our Members with Advanced Illness.

Alena Baquet-Simpson1, Claire M Spettell1, Allison N Freeman1

  • 1Aetna, a CVS Health Company, Hartford, Connecticut.

Journal of Palliative Medicine
|June 11, 2019
PubMed
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The Aetna Compassionate Care Program (ACCP) significantly increased hospice enrollment and reduced healthcare costs for advanced illness patients. This program improved patient outcomes and decreased hospital admissions in the final 90 days of life.

Area of Science:

  • Health Services Research
  • Palliative Care
  • Health Insurance Programs

Background:

  • Aetna launched the Aetna Compassionate Care Program (ACCP) in 2004 to enhance palliative and hospice care access for advanced illness members.
  • Evaluating the ACCP's impact on healthcare utilization and hospice enrollment is crucial for understanding its effectiveness.

Purpose of the Study:

  • To assess the effect of the Aetna Compassionate Care Program (ACCP) on healthcare utilization and hospice enrollment among its members.
  • To analyze changes in hospice use, medical costs, and healthcare visits in the final 90 days of life for ACCP participants versus a control group.

Main Methods:

  • Retrospective cohort study comparing ACCP participants with a matched control group using propensity score methodology.
  • Analysis included Aetna Medicare Advantage members enrolled in ACCP between January 2014 and June 2015.
Keywords:
Medicare Advantagecare managementcase managementhospiceutilization

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  • Primary outcomes measured hospice enrollment rates, days in hospice, and healthcare utilization (inpatient admissions, ER, primary/specialty care visits) and associated costs in the 30 and 90 days preceding death.

    • Main Results:

    • ACCP participants showed a 36% higher likelihood of hospice enrollment (79% vs. 58%, p < 0.0001).
    • Acute inpatient medical costs were reduced in the last 90 days of life for ACCP members ($4169 vs. $5863, p < 0.0001).
    • This cost reduction was primarily due to fewer inpatient admissions (860 vs. 1017, p < 0.0001) among ACCP participants.

    Conclusions:

    • Advanced illness case management programs, like ACCP, effectively improve access to hospice services.
    • These programs can enhance patient outcomes and reduce unnecessary hospital admissions during the critical final 90 days of life.
    • The ACCP demonstrates a successful model for integrating palliative and hospice care within a national health insurance framework.