Three research studies of programs and services offered by Mercy Maricopa Integrated Care (Mercy Maricopa), a Medicaid managed care plan, to address social determinants of health found some components of the programs can reduce cost and improve quality of care for people with serious mental illness in Maricopa County, Arizona.
Mercy Maricopa and one of its sponsors, Mercy Care Plan, are fully administered by Aetna Medicaid, which assumes the operational and management oversight of the health plans, including the hiring of all health plan staff and the provision of financial, clinical and operational services and systems. Mercy Care Plan and Mercy Maricopa are not-for-profit 501(c)(3) organizations. Mercy Maricopa is sponsored by Mercy Care Plan, Dignity Health, Ascension Health, and Maricopa Integrated Health System. Mercy Care Plan is sponsored by Dignity Health and Ascension Health.
Click the image to read the NORC at the University of Chicago study
The NORC studies looked at the experience of members enrolled in supportive housing, supported employment, and Assertive Community Treatment services, as well as the applicable program’s effect on the cost and quality of care and the utilization of services by adults with serious mental illness. The services in Maricopa County are combined at single community provider locations to make sure members have access to supportive services, as well as physical and behavioral health care.
The research findings suggest shifting services from more intensive inpatient and residential stays to outpatient and routine behavioral health care focused on chronic illness can affect cost and quality of care.
“Working collaboratively with providers, local stakeholders, the City of Phoenix, Valley of the Sun United Way, and the state of Arizona, we have shown that fully integrated care addressing social factors is the right way to meet the needs of Medicaid members with complex conditions,” said Mark Fisher, CEO of Mercy Care Plan.
“These studies validate the critical importance of addressing basic social needs to improve members’ physical and mental health,” said Laurie Brubaker, head of Aetna Medicaid. “Working with our community partners, Aetna Medicaid continues to invest in innovative tools and programs that can significantly improve the lives of our members, and the members we manage, right in their own communities.”
Addressing social determinants of health leads to positive health outcomes
The research found that members enrolled in the supportive Housing intervention experienced decreases in total cost of care of 24 percent after enrolling in the program, while members in the Assertive Community Treatment intervention experienced significant reductions in certain costs, including a 6 percent relative decrease in per member per quarter costs in behavioral health professional services, an 11 percent relative decrease in health facility costs, and an 8 percent reduction in emergency department visits.1
Members enrolled in the Scattered Site housing program had an average health care cost of about $20,000 per member per quarter in at least one quarter before starting in the supportive housing program.2 After enrolling in the supportive housing program, members experienced a $4,623 reduction per member per quarter in total cost of care. These members also had fewer psychiatric hospitalizations than they had before enrolling in the program.
While supported employment led to an increase in overall costs for enrolled members, likely because of the cost of the supported employment services and increases in other services, members who received supported employment services experienced varying degrees in reduction in both inpatient medical and psychiatric hospital stays, including a 35 percent decrease in inpatient medical hospitalizations.2
Continuing support for better community health
Mercy Maricopa and its partners showed a commitment to prioritizing member needs and a dedication to working with community stakeholders to ensure those needs were identified and addressed. Qualitative findings from this research suggests, that the increase in social support led to increased focus by members to obtain and regularly use sources of care – decreasing the need for emergency or inpatient services.
Integrated care streamlines the process of accessing care for members with serious mental illness. Having services within the clinics, for example, allows clinical teams to send a direct referral to a supported employment provider – enabling members to access these services immediately and reducing the interruption that occurs when members need to seek care somewhere else.
Continued education among clinicians and staff is also important to ensure they’re familiar with changes, additions, or new programs to help them provide better care to members. Mercy Maricopa created educational toolkits, known as Placemats or decision trees, to inform its staff of the discharge referral process. This way, members are provided with support and resources to help them remain healthy.
1. These reductions were per member per quarter and represent the approximate difference in total cost before and after the receipt of supportive housing services and are not necessarily directly attributable to the programs themselves. Each evaluation also included an analysis comparing those in the program to a matched group not in the program. For housing, this analysis found that there was a reduction in total cost of care of $5,002 per member per quarter relative to a comparison group.
2. These reductions were per 1,000 members per quarter and represent the difference in total cost of cost before and after the receipt of services and may not be directly attributed to the programs themselves. Each evaluation also included an analysis comparing those in the program to a matched group not in the program. Members in the Assertive Community Treatment program, averaged 187 fewer outpatient emergency department visits per 1,000 members per quarter relative to those who did not receive the services, which was a significant decrease in utilization.
Aetna Chairman and CEO Mark T. Bertolini is interviewed on CBS This Morning on Monday, Feb. 26, 2018. | Courtesy of CBS
The way the current health care system in the U.S. operates is backwards, Aetna Chairman and CEO Mark T. Bertolini said in an interview with CBS This Morning on Monday. The system, he said, needs to be fixed so it helps people achieve their health goals and live a life they want to lead.
“You don’t go to GMAC to buy a car, they finance cars. Health insurers are really financers of health care. We go to a dealership to talk about ambitions for our transportation – what it is that we want,” Bertolini said.
Understanding the unique issues affecting a person’s health will help solve the problems with the current health care system, Bertolini added.
“People don’t define their health as a disease; they define health as a barrier to living the life they want to lead,” he said. “… If we understand that person-by-person, we can actually solve that problem.”
Aetna CEO on proposed $69 billion acquisition by CVS - YouTube
Addressing the social determinants of health in a community can help people achieve their health goals. Sixty-percent of a person’s life expectancy is associated with where they live. Thirty-percent of their life expectancy is associated with their genetic code and 10 percent is the clinical care they receive.
“We’re going to keep people healthy around the issues that prevent them from living the life they want to lead,” Bertolini said.
When speaking about the proposed acquisition of Aetna by CVS Health, Bertolini said local CVS retail stores would be the “new front doors to the health care system.” The stores, he explained, would help people get healthy, instead of waiting for them to show up in the health care system broken and needing to be fixed.
No Offer or Solicitation
This communication is for informational purposes only and not intended to and does not constitute an offer to subscribe for, buy or sell, the solicitation of an offer to subscribe for, buy or sell or an invitation to subscribe for, buy or sell any securities or the solicitation of any vote or approval in any jurisdiction pursuant to or in connection with the proposed transaction or otherwise, nor shall there be any sale, issuance or transfer of securities in any jurisdiction in contravention of applicable law. No offer of securities shall be made except by means of a prospectus meeting the requirements of Section 10 of the Securities Act of 1933, as amended, and otherwise in accordance with applicable law.
Additional Information and Where to Find It
In connection with the proposed transaction between CVS Health Corporation (“CVS Health”) and Aetna Inc. (“Aetna”), on February 9, 2018, CVS Health filed with the Securities and Exchange Commission (the “SEC”) an amendment to the registration statement on Form S-4 that was originally filed on January 4, 2018. The registration statement includes a joint proxy statement of CVS Health and Aetna that also constitutes a prospectus of CVS Health. The registration statement was declared effective by the SEC on February 9, 2018, and CVS Health and Aetna commenced mailing the definitive joint proxy statement/prospectus to stockholders of CVS Health and shareholders of Aetna on or about February 12, 2018. INVESTORS AND SECURITY HOLDERS OF CVS HEALTH AND AETNA ARE URGED TO READ THE DEFINITIVE JOINT PROXY STATEMENT/PROSPECTUS AND OTHER DOCUMENTS FILED OR THAT WILL BE FILED WITH THE SEC CAREFULLY AND IN THEIR ENTIRETY BECAUSE THEY CONTAIN OR WILL CONTAIN IMPORTANT INFORMATION. Investors and security holders may obtain free copies of the registration statement and the definitive joint proxy statement/prospectus and other documents filed with the SEC by CVS Health or Aetna through the website maintained by the SEC at http://www.sec.gov. Copies of the documents filed with the SEC by CVS Health are available free of charge within the Investors section of CVS Health’s Web site at http://www.cvshealth.com/investors or by contacting CVS Health’s Investor Relations Department at 800-201-0938. Copies of the documents filed with the SEC by Aetna are available free of charge on Aetna’s internet website at http://www.Aetna.com or by contacting Aetna’s Investor Relations Department at 860-273-0896.
Participants in the Solicitation
CVS Health, Aetna, their respective directors and certain of their respective executive officers may be considered participants in the solicitation of proxies in connection with the proposed transaction. Information about the directors and executive officers of CVS Health is set forth in its Annual Report on Form 10-K for the year ended December 31, 2017, which was filed with the SEC on February 14, 2018, its proxy statement for its 2017 annual meeting of stockholders, which was filed with the SEC on March 31, 2017, and certain of its Current Reports on Form 8-K. Information about the directors and executive officers of Aetna is set forth in its Annual Report on Form 10-K for the year ended December 31, 2017, which was filed with the SEC on February 23, 2018, its proxy statement for its 2017 annual meeting of shareholders, which was filed with the SEC on April 7, 2017, and certain of its Current Reports on Form 8-K. Other information regarding the participants in the proxy solicitations and a description of their direct and indirect interests, by security holdings or otherwise, are contained in the definitive joint proxy statement/prospectus filed with the SEC and other relevant materials to be filed with the SEC when they become available.
The Private Securities Litigation Reform Act of 1995 (the “Reform Act”) provides a safe harbor for forward-looking statements made by or on behalf of CVS Health or Aetna. This communication may contain forward-looking statements within the meaning of the Reform Act. You can generally identify forward-looking statements by the use of forward-looking terminology such as “anticipate,” “believe,” “can,” “continue,” “could,” “estimate,” “evaluate,” “expect,” “explore,” “forecast,” “guidance,” “intend,” “likely,” “may,” “might,” “outlook,” “plan,” “potential,” “predict,” “probable,” “project,” “seek,” “should,” “view,” or “will,” or the negative thereof or other variations thereon or comparable terminology. These forward-looking statements are only predictions and involve known and unknown risks and uncertainties, many of which are beyond CVS Health’s and Aetna’s control.
Statements in this communication regarding CVS Health and Aetna that are forward-looking, including CVS Health’s and Aetna’s projections as to the closing date for the pending acquisition of Aetna (the “transaction”), the extent of, and the time necessary to obtain, the regulatory approvals required for the transaction, the anticipated benefits of the transaction, the impact of the transaction on CVS Health’s and Aetna’s businesses, the expected terms and scope of the expected financing for the transaction, the ownership percentages of CVS Health’s common stock of CVS Health stockholders and Aetna shareholders at closing, the aggregate amount of indebtedness of CVS Health following the closing of the transaction, CVS Health’s expectations regarding debt repayment and its debt to capital ratio following the closing of the transaction, CVS Health’s and Aetna’s respective share repurchase programs and ability and intent to declare future dividend payments, the number of prescriptions used by people served by the combined companies’ pharmacy benefit business, the synergies from the transaction, and CVS Health’s, Aetna’s and/or the combined company’s future operating results, are based on CVS Health’s and Aetna’s managements’ estimates, assumptions and projections, and are subject to significant uncertainties and other factors, many of which are beyond their control. In particular, projected financial information for the combined businesses of CVS Health and Aetna is based on estimates, assumptions and projections and has not been prepared in conformance with the applicable accounting requirements of Regulation S-X relating to pro forma financial information, and the required pro forma adjustments have not been applied and are not reflected therein. None of this information should be considered in isolation from, or as a substitute for, the historical financial statements of CVS Health and Aetna. Important risk factors related to the transaction could cause actual future results and other future events to differ materially from those currently estimated by management, including, but not limited to: the timing to consummate the proposed transaction; the risk that a regulatory approval that may be required for the proposed transaction is delayed, is not obtained or is obtained subject to conditions that are not anticipated; the risk that a condition to the closing of the proposed transaction may not be satisfied; the outcome of litigation related to the transaction; the ability to achieve the synergies and value creation contemplated; CVS Health’s ability to promptly and effectively integrate Aetna’s businesses; and the diversion of and attention of management of both CVS Health and Aetna on transaction-related issues.
In addition, this communication may contain forward-looking statements regarding CVS Health’s or Aetna’s respective businesses, financial condition and results of operations. These forward-looking statements also involve risks, uncertainties and assumptions, some of which may not be presently known to CVS Health or Aetna or that they currently believe to be immaterial also may cause CVS Health’s or Aetna’s actual results to differ materially from those expressed in the forward-looking statements, adversely impact their respective businesses, CVS Health’s ability to complete the transaction and/or CVS Health’s ability to realize the expected benefits from the transaction. Should any risks and uncertainties develop into actual events, these developments could have a material adverse effect on the transaction and/or CVS Health or Aetna, CVS Health’s ability to successfully complete the transaction and/or realize the expected benefits from the transaction. Additional information concerning these risks, uncertainties and assumptions can be found in CVS Health’s and Aetna’s respective filings with the SEC, including the risk factors discussed in “Item 1.A. Risk Factors” in CVS Health’s and Aetna’s most recent Annual Reports on Form 10-K, as updated by their Quarterly Reports on Form 10-Q and future filings with the SEC.
You are cautioned not to place undue reliance on CVS Health’s and Aetna’s forward-looking statements. These forward-looking statements are and will be based upon management’s then-current views and assumptions regarding future events and operating performance, and are applicable only as of the dates of such statements. Neither CVS Health nor Aetna assumes any duty to update or revise forward-looking statements, whether as a result of new information, future events or otherwise, as of any future date.
Retiree health coverage is an important component of the benefit packages that employers and unions offer their workers. Yet, today, only 25 percent of employers with 200 or more employees offer health benefits for their retirees — a decrease from 40 percent in 1999 and 66 percent in 1988.1
The employers that continue to provide coverage are increasingly seeking innovative ways to manage costs while offering high-quality retiree benefits. Medicare Advantage Employer Group Waiver Plans (MA-EGWPs) are proving to be an increasingly attractive option.
MA-EGWPs provide employers the opportunity to fulfill their promise to maintain consistent coverage for their former employees. EGWP Preferred Provider Organizations (PPOs) allow employers to maintain this commitment, regardless of where their former employees choose to live in retirement. While the individual Medicare Advantage market is comprised mostly of local health maintenance organization (HMO) plans, over 70 percent of MA-EGWPs are PPO plans, tailored to serve retirees living in widespread areas.2
As part of the 2019 Medicare Advantage (MA) and Part D Advance Notice, however, CMS is proposing to cut payments to these EGWP plans. CMS is proposing to fully transition in 2019 to using only individual market plan bids to set payments for MA-EGWPs. Given the differences in the composition of the EGWP and individual MA markets, using bids that mostly reflect HMO structures to set payments for plans that mostly offer PPO structures could cause unintentional coverage disruption for retirees.
As CMS seeks to finalize this policy, Aetna is urging the agency to take into account the dynamics of the employer retiree market and determine payments to this market accordingly. Specifically, to maintain predictability and stability, CMS should implement an adjustment that takes into account the difference in the benefit structure of HMOs vs. PPOs, even within the EGWP market. In doing so, CMS would ensure that EGWP HMOs are not over-paid and EGWP PPOs are not under-paid. We are also asking that CMS phase-in any final payment changes to this program over the next two years rather than one year.
Millions of people depend on MA for quality, patient-centered health care. With over 3.4 million MA-EGWP enrollees today, it is important CMS take steps to minimize disruption to this program and help employers maintain this seamless form of coverage to their former employees.
Despite the United States’ position as an economic powerhouse at the forefront of the tech boom, our health lags behind some countries. World Health Organization1 (WHO) figures show that our average life expectancy is lower than 30 other countries, including Switzerland, Australia and Canada. But the tide may finally be turning, with a monumental shift in how we approach health care, towards a personalized approach that focuses on each individual and all aspects of their well-being. Rather than concentrate solely on treating people when they’re sick, health care providers are placing a greater emphasis on keeping them healthy. Instead of visiting clinical facilities for the majority of their care, people are using technology to monitor their health and receive treatment in their homes.
Doctors, hospitals and health companies now have insight into all factors that can affect patient health – from lifestyle to income to genetics. And they are using that information to connect people to a wide range of health and social services within their communities.
The Aetna 2018 Health Care Trends Report explores the key factors driving this shift: New strategies that yield better results from our country’s investment in health care; innovative ways wearables could reduce spending on chronic diseases; the role of diversity in shaping a new health care system; how health companies can help conquer the scourge of opioid addiction. Read on to see how the development of these trends in the years to come can result in healthier communities, happier individuals and better health outcomes for all.
1 World Health Organisation – Global Health Observatory data http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/
For over a decade, Aetna has been focusing on transforming the health care delivery system. Members are at the center of Aetna’s accountable care organizations, with the goal of improving health by providing access to high-quality, effective, patient-centric care.
Accountable care organizations are integrated networks of hospitals, doctor offices and other health care facilities that get paid by an insurer based on the quality and effectiveness of care their patients receive. Aetna has over 500 accountable care organization arrangements across its Commercial and Medicare lines of business.
Aetna’s accountable care organizations have seen broad successes. At 4 in every 5 accountable care organizations, members were more successful in managing chronic diseases, such as diabetes and heart disease, than members who did not participate in a similar care model.1
Members of Aetna accountable care organizations also saw an average savings of $29.25 per month from June 2015 to June 2016.2 And an October 2017 study of Aetna accountable care organizations found there were lower costs for emergency room, inpatient and physician visits in 2016.3
“Accountable care organizations combine the best of both worlds by bringing together the capabilities of a health insurer focused on wellness with all that health systems, doctors, and other care givers across the community do to deliver high quality care,” said Paul McBride, CEO of Accountable Care Solutions at Aetna. “These collaborations are helping to drive improvement in outcomes, affordability and access for our members. We aren’t only focused on the care members receive when they have chronic or acute health care needs. We also are committed to providing a better member experience and helping members achieve their health and wellness goals.”
Accountable care organizations take a proactive approach to health care. Rather than waiting until members visit a doctor’s office, care teams use technology and digital tools to connect with them in between appointments. The arrangements allow clinicians to have more information about a patient when they visit, including if they’re regularly filling prescriptions or the results of recent tests.
Increased engagement with the patient also can result in the need for fewer in-person appointments, McBride said.
In Arizona, Aetna and Banner Health had a five-year accountable care organization arrangement called “Aetna Whole HealthSM – Banner Health Network.” The relationship has led to:
A 24 percent decrease in avoidable surgery admissions;
A 4 percent increase in generic prescribing; and
An 11.5 percent overall reduction in medical costs.
The success of Aetna Whole HealthSM – Banner Health Network led to the development of Banner|Aetna, a joint venture aimed at bettering the member experience and improving health outcomes and engagement with providers while reducing the cost of health care in Arizona.
In 2016, Aetna launched Aetna Premier Care Network Plus, a plan focused on simplifying health care access and services for members by putting many high-performing accountable care organizations together in a common network. Members can then easily find in-network providers that provide high-quality care in 47 of the largest communities coast to coast.
Aetna Premier Care Network Plus is built on providing both simplicity and quality. Specialists and hospitals in the network use data-driven decision making and shared clinical pathways to improve quality and efficiency. On average, this results in shorter hospital visits and fewer hospital readmissions.
Aetna Premier Care Network Plus is configured to produce the greatest medical cost savings through designated providers, who are chosen based on measures of quality and efficiency that lead to improved outcomes.
Care Teams Support Members
Helping people achieve their health goals means supporting them outside of the doctor’s office. Whether it’s connecting members to specialists or community services or answering questions about medications, accountable care organization care teams can help better coordinate care.
For example, Aetna’s Delaware Valley accountable care organization sent a social work care coordinator and nurse care coordinator to conduct a home visit with a 75-year-old patient. The member’s doctor was concerned her medical condition and living situation put her at an increased risk for a fall. The member’s care goals included living at home and maintaining independence.
The member had a chronic, neurological disease impairing her motor skills and muscle control. She fell several times when trying to stand up from a chair and while retrieving items in another room. The care coordinators also discovered the member was unable to carry meals from her kitchen to the living room while using a walker.
The care coordinators:
Connected the member to a local volunteer program that delivers weekly meals.
Set the member up with a medical alert system that would call for help in the event of a fall.
Found a charitable organization to pay for a chair lift to help her safely stand from sitting in her chair.
Set the member up to receive physical and occupational therapy in her home.
The care coordinators followed the member’s progress for six months. With the additional assistance and resources, she avoided falls and emergency room visits, while still living on her own. This is the type of member experience Aetna strives to make the norm. Accountable care organization relationships support that outcome.
112 months through June 2016 versus 12 months through June 2015. Market comparison includes all attributed non-value-based contract members. Results exclude individual, student health and coordination of benefits. Results differ due to differences in time periods and adjustments.
2Compared to broad Aetna network plans. Actual results may vary; savings may be less when compared to other value-based or narrow network plans.
3Inaugural ACO Product Evaluation Study results, October 2017, for members with 2016 effective dates. 12-month baseline period prior to ACO effective date and 12-month study period after ACO effective date.
The Aetna Foundation is launching a funding initiative to fight the ongoing opioid epidemic in the U.S. and help communities and states that have been particularly hard hit. Grants totaling $6 million will fund state and local projects with the potential to make a real difference in addressing opioid-related challenges.
North Carolina will be the first state to receive a grant through the Aetna Foundation’s initiative. The North Carolina Harm Reduction Coalition will receive $1 million to help fund its “Rural Opioid Overdose Prevention Project.”
“While this is a national health crisis, there is no single solution that can be applied across the country,” said Harold L. Paz, M.D., M.S., Aetna’s executive vice president and chief medical officer and member of the Aetna Foundation Board of Directors. “These grants will provide important resources to empower local communities to address the unique characteristics of the opioid-related problems they are facing.”
In a survey conducted by Morning Consult, 77 percent of respondents said the role of local communities and community organizations are important in fighting the opioid epidemic. The survey was conducted from Feb. 8 through Feb. 12, 2018, and 2,201 adults participated.
With one of the highest rates of opioid overdose deaths nationwide, the funding will help provide community-level risk education in five rural counties in North Carolina; distribute naloxone kits to rural, high-risk opioid users; and increase adoption of best practice policies on overdose prevention.
More than 12 million people in the U.S. misuse prescription opioids, according to the most recent data from the United States Department of Health and Human Services. The number of overdose deaths involving opioids in 2016 was five times higher than in 1999, according to the Centers for Disease Control and Prevention.
In 2010, drug overdoses overtook motor vehicle crashes to become the leading cause of injury death in North Carolina. An average of five people a day died from drug overdoses in North Carolina in 2016, according to the North Carolina State Center for Health Statistics.
“There’s no question that rural communities in North Carolina have been especially hit hard by this epidemic. There are far too many tragic stories of lives being lost and families bearing the burden,” said North Carolina Attorney General Josh Stein. “North Carolina Harm Reduction has been doing excellent work to confront these challenges. I am grateful to Aetna for supporting North Carolina Harm Reduction to save lives in North Carolina communities.”
The Aetna Foundation will be announcing grants to other organizations in additional states over the next several months as part of its mission of Building Healthy Communities by supporting locally-based programs, dynamic partnerships, and proven models that can help accelerate progress everywhere.
“For the first time in our history, our children’s generation is not expected to live as long as our own. That is due in large part to the epidemic of opioid abuse, which presents a clear and present threat to our communities and health care resources,” said Garth Graham, M.D., M.P.H, president of the Aetna Foundation and vice president of Community Health for Aetna. “The innovative work that the North Carolina Harm Reduction Coalition is doing on the ground is promising, and it’s our hope that it can also offer a road map for outreach in other rural communities.”
When 18-month-old Simon Sparrow woke up one morning in spring 2004, he was ill. By the afternoon, his face was swollen and he was having difficulty breathing. His parents brought him to the hospital, where he was diagnosed with septic shock and received antibiotics.
The next morning, Simon was dead.
Simon’s death was caused by methicillin-resistant Staphylococcus aureus, or MRSA. An indirect cause of Simon’s death was antibiotic resistance and the decades of overuse and misuse of drugs like methicillin, a synthetic version of penicillin.
Click the image to read the white paper.
Antibiotics are used to fight infections caused by bacteria. The overuse and misuse of antibiotics is accelerating the creation and spread of resistant bacteria, otherwise known as “superbugs.”
In a January 2018 white paper called, “Antibiotic resistance: Toward better stewardship of a precious medical resource,” Aetna International argues the antibiotic resistant bacteria crisis must be addressed through a global effort. The company believes the world must be better stewards of the antibiotics available today, while also working to develop more antibiotics for the future and address the underlying issues that led to the crisis.
“Stemming the rising tide of antibiotic resistance will take a global, multi-pronged effort. The industry must become better stewards of the antibiotics we have today, whilst working to develop more antibiotics for tomorrow,” said Mitesh Patel, M.D., a medical director at Aetna International. “A focus on harnessing big data will inform strategies that create better care for patients, as well as significantly decreasing the financial cost from antimicrobial resistance.”
The Centers for Disease Control and Prevention (CDC) estimates at least 2 million people become infected with antibiotic resistant bacteria each year in the U.S. Of those infected, about 23,000 dies from difficult to treat infections.
Although the biological causes of antibiotic resistant bacteria can’t be prevented, Aetna believes the societal causes – over-prescribing and misuse, use of antibiotics in agriculture, lack of research and poor hygiene and sanitation – can be addressed.
In the U.S., about 13 percent of outpatient visits, or 154 million visits each year, result in an antibiotic prescription, according to the Pew Charitable Trusts. Thirty percent of those prescriptions, or 47 million prescriptions, are deemed unnecessary.
Aetna sent letters to more than 1,100 clinicians in the United States in July 2017, who prescribed antibiotics to treat acute bronchitis, which is caused by a viral infection. The letters included information from the CDC on antibiotic resistant bacteria. This correspondence resulted in a significant percentage of the clinicians requesting further engagement with Aetna to tackle the issue.
The white paper also describes how health systems across the world are working to address the antibiotic resistant crisis. In India, multiple factors, such as high burden of disease, poor public health infrastructure, rising incomes and unregulated sale of cheap antibiotics, led to the country becoming one of the world’s largest consumers of antibiotics.
Indian Health Organization, an Aetna company, is taking a three-pronged approach to combat this. There is an emphasis on antimicrobial stewardship in clinical training. Audited medical consultations also include checking antibiotic prescriptions for dosage, duration and rationale for use. Physicians are also identifying and correcting antibiotic usage during consultations.
Aetna is also working with providers and members to increase awareness and education about antibiotic resistant bacteria and appropriate antibiotic use. The approach has led to antibiotic utilization across Aetna International’s membership to drop from 27 percent in 2014 to 18 percent in 2016.
Other organizations have also starting to take an increased look at combatting the antibiotic resistant bacteria crisis, according to the white paper. After Simon’s death in 2004, his mother partnered with the University of Chicago Medical Center and found the MRSA Research Center. The Research Center seeks to prevent, control and treat MRSA through scientific and clinical research, according to its website.
Healthiest Cities and Counties Challenge Spotlight Award Winners - YouTube
Ten U.S. community health programs participating in the Healthiest Cities & Counties Challenge received the Aetna Foundation’s “Spotlight Award.” The awardees will receive a $25,000 prize to further support their programs, which will help build sustainable models that can be used in other communities.
“Where a person lives has a profound impact on how they live – particularly when it comes to their health,” said Mark T. Bertolini, the chairman of the Aetna Foundation and chairman and CEO of Aetna. “The Spotlight Award recipients are outstanding examples of how important progress can be made when communities work together to look at the biggest issues facing their neighborhoods and develop healthy, home-grown solutions.”
The Spotlight Awards highlight the early success stories from participants that have demonstrated significant progress since the launch of the Healthiest Cities & Counties Challenge.
“Communities invest heavily in local residents’ health and well-being, often serving as a safety net for low-income and vulnerable residents,” said Roy Charles Brooks, president of the National Association of Counties. “We know just as each community is unique, so too are the health challenges they face. These award winners are examples of what can be achieved when counties work with community partners to solve serious, complex public health issues.”
In addition, five community health programs were recognized as Honorable Mention awardees and will receive a $10,000 prize to advance their work. The programs are a part of the Healthy50 — thee 50 finalists in the Healthiest Cities & Counties Challenge, which will award $1.5 million in prizes to cities and counties that show measurable improvements in health outcomes over the course of several years through cross-sector partnerships.
“Since the Challenge launched, we have seen numerous improvements and advancements in the health of the 50 participating communities,” said Georges C. Benjamin, M.D., executive director of the American Public Health Association. “The Spotlight Awards are a moment to showcase the innovative work being done in cities and counties to address social determinants of health.”
Healthiest Cities & Counties Challenge: Helping Improve Community Health - YouTube
Spotlight Award Winners
Bridgeport Coalition United to Reach Equity — Connecticut
Healthiest Cities and Counties - Bridgeport, Connecticut - YouTube
Bridgeport Coalition United to Reach Equity, a project designed to help residents of Bridgeport address the lack of fresh fruits and vegetables in their community.
The East End Neighborhood Revitalization Zone’s Pop-up Market leveraged its strategic community partnerships and made a concerted effort to include residents in the entire community engagement process. The process included job creation, types of job training programs and identifying small businesses for development training to improve access to healthy, affordable food in the East End community.
iGrow Food Network — Florida
Tallahassee Leon County is working to address pockets of food source inequality in Tallahassee and Leon County.
The iGrow Food Network is a culturally-competent youth empowerment and urban agriculture entrepreneurship program of the Tallahassee Food Network that leverages community partnerships to focus on education, outreach and community engagement to achieve food security in USDA-designated food deserts by increasing healthy food access.
Live Healthy Little Havana — Florida
Healthiest Cities and Counties - Miami, Florida - YouTube
Live Healthy Little Havana’s goal is to strengthen community capacity to collaboratively plan and collectively carryout strategies to improve health. Residents are addressing physical activity, primary care and improving the community’s walk score.
West Louisville Outdoor Recreation Initiative — Kentucky
West Louisville Outdoor Recreation Initiative Louisville Metro Government intends to build culture residents connect to nature to improve physical and mental health by increasing physical activity and reducing toxic stress, as well as increasing social cohesion to deter crime.
The West Louisville Outdoor Recreation Initiative created multiple annual paths through its parks department and community partners. The paths allow youth ages 3 to 19 to engage with nature.
The SMART Initiative — New Jersey
The SMART Initiative will reduce the number of sewer overflows to improve water quality in waterways and green infrastructure with a robust focus on community input and guidance.
The Initiative reengages diverse residents through innovative community meetings, forums, large scale events and mobile applications to educate residents on the impact of combined sewer systems and green infrastructure.
Chatham Health Alliance — North Carolina
Healthiest Cities and Counties - Chatham County, North Carolina - YouTube
Chatham Health Alliance is implementing a multilevel initiative targeting obesity, the leading health issue identified in a 2014 Community Health Assessment.
The project leverages partnerships built between the Health Department, the Alliance and numerous stakeholders by embedding a Health in All Policies approach in the Chatham Country Comprehensive Plan, which sets the vision for the county over the next 25 years.
Village HeartBEAT — North Carolina
Healthiest Cities and Counties - Mecklenburg County, North Carolina - YouTube
The Village HeartBEAT program is working to reduce the incidence of heart disease in the Public Health Priority Areas zip codes.
The program works in collaboration with all members of faith-based organizations and leaders to engage and ensure that everyone in Mecklenburg County enjoy good health, regardless of their race, ethnicity, gender, disability, age or socioeconomic status.
The Heart of Texas Urban Gardening Coalition — Texas
Healthiest Cities and Counties - Waco-McLennen County, Texas - YouTube
The Heart of Texas Urban Gardening Coalition is helping residents in three zip codes to more easily access and eat healthy foods by promoting current resources of fresh and locally grown food, hosting nutrition education sessions, and utilizing community health workers to connect residents to resources, as well as providing fresh produce delivery.
The Coalition partners with Waco area organizations to create awareness and access to the available fresh local produce by utilizing local vendors and resources, such as the Mobile Farmer’s Market.
Health Collaborative — Virginia
Healthiest Cities and Counties - Danville and Pittsylvania County, Virginia - YouTube
The Health Collaborative has created action teams in four areas: healthy eating, active living, access to health care and cross-cutting approaches.
The Health collaborative focuses on policies, systems and environmental change to support the creation of effective and inclusive policies. The Collaborative is providing access to food and opportunities for physical activity.
Active Design for a Healthier Thurston County — Washington
Healthiest Cities and Counties - Thurston County, Washington - YouTube
Thurston County addresses the need for better conditions to support physical activity in key county areas to increase access to and promotion of the trail system.
The project developed and applied web-based tools for data collection and display of information as part of the “walkshed” analysis, which measured the walkability around various locations. The analysis was aimed at boosting physical activity levels.
Food is Medicine — Florida
Healthiest Cities and Counties - St. Petersburg, Florida - YouTube
The Food is Medicine program aims to improve the health of people living in food deserts or low-income/low food access areas of St. Petersburg, Florida. The program offers residents access to low cost produce, increases educational opportunities and works to eliminate barriers to health.
The program uses a multifaceted approach to improve health behaviors and influence change. It uses education, community collaboration, biometric screenings and participant incentives. The program also offers evidence-based curriculum in areas such as wellness, nutrition, healthy cooking, budgeting for healthy eating, fitness, childhood obesity prevention, diabetes and other chronic diseases.
Be Well, B’More — Maryland
Healthiest Cities and Counties - Baltimore, Maryland - YouTube
The goal of Be Well, B’More is to increase physical activity and promote activities unifying Baltimore residents in the city’s outdoor space across neighborhoods.
The program uses trusted local partners within the neighborhoods through new cross-sector collaborations. Community organizations, such as Girl Trek and health Freedom Inc., as well as media partners, such as WBAL and the Baltimore Sun, allowed the program’s reach to expand.
Blue Print for Violence Reduction — New Jersey
Healthiest Cities and Counties - Jersey City, New Jersey - YouTube
Jersey City, New Jersey, reclassified community violence as a health issue. The project aims to promote healthier behaviors as a strategy for reducing violence.
Organizations worked together to focus on improving youth health in new and engaging ways that include non-traditional activities, such as chess and yoga, and violence interruptions, including “Occupy the Block” events.
The North Carolina Healthiest Counties Cross-Sector Team — North Carolina
HCC Innovator County: Durham and Cabarrus Counties - YouTube
The North Carolina Healthiest Counties Cross-Sector Team seeks to improve population health, payment reform and health equity in both Cabarrus and Durham Counties by addressing nutrition/food insecurity, physical activity, tobacco use, integrating physical activity “prescriptions” into clinical care and piloting health care delivery and payment reform through community health workers.
The Durham County Health Department and its partners launched public policy changes to encourage greater utilization of Community Health Workers to improve the physical and financial health of the county to improve the physical and financial health of the county.
Walk Works ChesCo! — Pennsylvania
The program’s goal is to promote, educate and empower people to adopt a healthier lifestyle by encouraging residents to walk through the Walk Works ChesCo! Program.
The program reached out to a diverse group of partner organizations to promote the challenge to get community members engaged. The group was actively engaged in planning, implementing and participating in the Challenge. Walk Works routes were announced in Coatesville and Phoenixville.
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