Transcript: Aetna Story Healthier Care
- Shawn Franklin
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Value based care is about improving quality and lowering costs.
- Kenneth Homer
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Rather than concentrating on a system that’s focused on reimbursement based on volume, we’re now focusing on what we should be focusing on and that’s keeping patients well.
- Brigitte Nettesheim
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It’s about outcomes; it’s about the experience of patients.
- Kenneth
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Patients will note that it’s more of a team concept than it used to be. That team might consist of the physician as the foundation, care manager nurses, pharmacists, case managers, social workers.
- Doreen Smiley
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I am a care manager, I call patients to make sure that they have a primary care doctor; I call them to check on their health.
- Kenneth
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We’re able to navigate them more efficiently through the healthcare system to get them better, more timely care.
- Simonne
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About a week after I had surgery I developed a fever and I had to be admitted to the hospital. I had a pelvic abscess and a couple of different infections as well as I had been diagnosed with ? .
- Doreen
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When I called Simonne, she was still recovering at her parents’ house on the west coast.
- Simonne
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I was at the point where I was like okay, I need to go to the ER and just tell them that I need this strain pulled and I need this pickline pulled, and at that point Doreen said, “hold on a second, don’t do that.”
- Doreen
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A lot of surgeons don’t want to touch anybody else’s work, so it was very important for me to help her collaborate her care.
- Simonne
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She was actually calling doctors on my behalf, and trying to get surgery scheduled.
- Kenneth
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We developed a communication system so that we could all communicate and share information about the same patient which is extremely important and which has been a gap in healthcare for a long time.
- Brigitte
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That’s the power of the information that we can pull together in working with providers collaboratively.
- Doreen
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We collaborated with the medical director and we were able to set her up with a surgeon here.
- Simonne
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Doreen was instrumental at making sure that I got things done and move appointments up and spoke with doctors.
- Doreen
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Simonne had one person on her side that she could call when she needed help getting into any place, and that was me. I love what I do. I love being able to speak to the patients, and to help educate them.
- Kenneth
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As a primary care doctor and an internist, I believe in this change from volume to value, I believe it’s long overdue.
- Simonne
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On a scale of 1 to 10 I would say that my experience with Doreen has been 11. It goes outside of the scale.