New Accountable Care Collaboration Between Aetna & Zoom+Care in Oregon

Aetna Teams Up with Zoom+Care for Innovative Employer Plans

Aetna, one of the largest health insurers in the United States, is hoping to disrupt the employer-based health insurance market in the Portland area by teaming up with Zoom+Care.

As medical costs around the country continue to rise exponentially, and our dysfunctional Congress remains deadlocked and unwilling to address the issue, insurers and providers alike are seeking out alternative models to lower costs and provide better medical access to their customers.

Aetna and Zoom+Care are hoping their partnership in the Oregon counties of Washington, Clackamas, and Multnomah, encompassing the Portland metro region, will provide a successful blueprint that can be reproduced nationwide.

Norm Seabrooks, President of Aetna’s Northwest operations said “Aetna is pleased to work with ZOOM+Care to provide a simpler and more efficient health care experience for our members in Oregon.

Who are Aetna and Zoom+Care?

Aetna, headquartered in Hartford, Connecticut, covers almost 40 million Americans with an array of insurance plans and health services, including medical and dental services, and with a foothold in pharmacy, healthcare IT, workers’ compensation, Medicaid, and behavioral health. Their health insurance plans are available to both employers and are sold on an individual basis.

Zoom+Care is based out of Portland, providing retail and digital medical services across 36 clinics, serving neighborhoods in both Portland and Seattle. The company currently provides care to over 200,000 patients each year, with locations for urgent needs, primary and secondary care, and mental health services, along with a robust and growing presence in the field of telemedicine.

Zoom’s mission, as established by its founders, both doctors, is known as Twice. ½. Ten. It is a pledge to Zoom’s customers and patients to provide twice the health, at half the cost, and with ten times the delight.

Zoom was the original neighborhood, retail clinic, pioneering online scheduling for same-day appointments, transparent pricing available online, and spearheading the legal challenge to allow clinics to dispense prescriptions. The company was also instrumental in encouraging insurance companies to reimburse for telemedicine and online health exams.

What is the Aetna Whole Health – Zoom+Care Plan?

The new and innovative accountable care plan created by the two companies, known as the Aetna Whole Health℠ – ZOOM+Care plan, will be rolled out in July. Initially, the plan will only be available to large employers, headquartered in the three Portland-area counties. The plans are bespoke, individualized to each employer, but Aetna and Zoom are promising savings of up to 15% annually, over more traditional insurance plans.

The idea of the plan, and the reason for Aetna insurance company to team up with Zoom’s provider network, is to create a more coordinated, easier to manage health network for customers and patients.

Members of the plan will be able to coordinate all medical needs from their phone. Online access will include scheduling, lab results, and the entirety of the patient’s medical record. Zoom+Care will also provide members of the plan with emergency access, when and as needed, at its Zoom+Care Super Clinic, in addition to a large network of local hospitals and specialty doctors.

It is Aetna’s hope that by utilizing Zoom’s well-established network, its members will find navigating the, at times challenging, ropes of modern healthcare to be easier and less stressful than in the past.

How Does the Plan tackle Soaring Healthcare Costs?

This is the big question, and ultimate goal, of this innovative partnership between insurer and provider. Aetna hopes the alliance with Zoom will allow the insurer to spearhead the charge towards a value-based healthcare system; one that pays for quality over quantity.

The reimbursement model between Aetna and Zoom will be based on a number of factors, including efficiency, patient satisfaction, preventative screenings, chronic disease management, and a decrease in emergency room utilization and hospital readmissions.

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