Aetna Services

Our services include:

• Data Management & decision support

  Intake and manipulation, analysis, reporting and decision support
  
  We have extensive experience managing a data warehouse in the US that has 14 terabytes of data, 16 major medical expenditure categories, 310 minor categories with just under 500,000 data attributes. Turning data into actionable information is a critical starting point and driver of a successful commissioning cycle. We do more than just analyse data and predict demand; we focus on actionability to drive results for our clients. For instance, we have developed processes and capabilities to understand health needs based on life stage, burden of illness, and by race and ethnicity to design programme interventions that address long-standing healthcare inequalities.

• Care & resource utilisation management

  Core utilisation management, medical best practices/patient safety, disease management, service design, quality improvement strategies
  
  Our experience includes the design, development, and implementation of care and resource utilisation programmes. Aetna's programmes, underpinned by advanced techniques for the analysis of information, demonstrate quantifiable impacts on clinical effectiveness, the use of appropriate care pathways, and reduction in expenditure.
  
  Aetna designed care and resource utilisation programmes support and improve care coordination between the physician and their patient, improving health whilst promoting more efficient use of resources. These programmes help ensure that the most appropriate persons receive evidence based care, in the suitable setting, at the right time. Specific Aetna programmes include referral review, concurrent review and in-facility case management based on evidenced base clinical admission and discharge criteria, proactive discharge planning processes, and disease management.

• Contracting

  Contracting strategy; contract development; negotiations support; contract management and monitoring
  
  Implementation of robust contracting programmes with an emphasis on outcomes and value are important to achieving better healthcare for patients. Aetna has developed tools, techniques, and replicable processes to contract with and manage over 783,000 provider relationships in the United States. Globally the company has relationships with over 740 facilities, including 90 in the UK.

• Performance Management

  Management process design and execution
  
  World class performance management is about executing to a set of rigorous and repeatable practices that informs and aligns actions to results. At Aetna, we have a proven management process that produces consistent reporting, draws senior management focus, facilitates best practice sharing, and identifies clear corrective actions and accountabilities. We have the ability to take a system wide view to performance management. The ability to take an integrated view of commissioning is what will ultimately drive sustainable improvements.

• Stakeholder Engagement

  Stakeholder engagement planning and strategies, public consultations, stakeholder research (patient, provider, etc.), patient choice, information and education services
  
  

  Achieving the NHS vision for system reform will require effective engagement across many stakeholders in the health economy.  We believe a particularly critical ingredient for success is clinical engagement.  We have a strong record of collaborating with clinicians to achieve mutual benefits and ultimately, improving care for patients.  We have employed techniques such as peer reviews, patient forums, comparison tools with great success.  It is also important to recognise that engagement is not a one time exercise - the key is to instil the discipline and mindset for continuous engagement.

• Training & Education

  

  Training needs assessment and planning; training programme/content development, and delivery

  
  As commissioning capabilities evolve and mature, so will the need to train / up-skill commissioning staff. We recognise the importance of training and education and its impact on creating a high performing organisation. From succession strategies, formal mentoring, certification, and train the trainer programmes, we can assess, design, and implement the right training and education plan for your organisation. We can draw from our direct experience to deliver content on any aspect of the commissioning cycle for all levels.