Aetna Picky About New Docs Lineup

October 1, 2003 (PLANSPONSOR.com) - Aetna is slated to offer benefit managers access to a newly designed network of specialist physicians who are effective clinicians and efficient users of health-care resources.

Aetna announced it was selling the new Aexcel network in Dallas/Fort Worth, North Florida, and Seattle/Western Washington with an effective date of January 1, 2004. The more select network is offered as an option to self-insured employers, who fund their own health plans.

They can direct their workers to use only Aexcel ¬†physicians. Or employers can offer Aexcel to workers along with Aetna ‘s broader network of specialists. If both networks are offered to a workforce, employees would typically be charged a higher co-pay to see physicians who aren’t in Aexcel .Physicians in six medical specialties – cardiology, cardiothoracic surgery, gastroenterology, general surgery, obstetrics/gynecology, and orthopedics – who met established measures will be in Aexcel .

According to the announcement, Aetna identified medical specialties associated with large portions of health-care spending and began adding¬†specialists who demonstrate effectiveness against certain clinical measures, the volume of Aetna members’ cases, and efficient use of health care resources. Evaluation components include analyses based on Episodes of Care technology, a analytic tool that looks at health outcomes and medical costs and data.

Aetna serves approximately 13 million medical members, 11.3 million dental members, and 11.7 million group insurance customers, as of June 30, 2003. For more information, go to www.aetna.com .

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