Aetna Expands Clinical Collaboration Program to Reduce Medicare Readmissions
Aetna, a CVS Health company, announced the expansion of its Aetna Clinical Collaboration (ACC) program to ten hospitals by the end of 2025. The ACC program embeds Aetna nurses within hospital staff to provide coordinated care for Medicare Advantage members, particularly focusing on the transition from hospital to home or skilled nursing facilities. This program addresses the high readmission rates among Medicare-insured patients, where nearly 20 percent are readmitted within 30 days of discharge. The collaboration aims to reduce 30-day hospital readmissions and emergency visits while alleviating administrative burdens for hospital personnel.
Initially launched earlier in 2025, the ACC program has engaged about 25% of its members with dedicated Aetna care managers. Projected outcomes include a 5% year-over-year reduction in 30-day readmissions and shortened hospital stays. The program is part of Aetna's larger strategy to improve outcomes for its over 4 million Medicare Advantage members, with further expansion planned for 2026, including rollout in the commercial insurance segment.
Hospital discharge periods are recognized as vulnerable moments in patient care, often complicated by new diagnoses, medication management, and care coordination challenges. The ACC program's integrated model supports healthcare teams by ensuring patients receive proper services and follow-ups to avoid complications and readmissions.
Aetna, with a broad portfolio encompassing medical, pharmacy, dental, and behavioral health plans, leverages this clinical collaboration approach to drive better health outcomes and support its members across multiple care settings. CVS Health's integrated services and pharmacy benefits management also complement these efforts, targeting improved access to quality care and cost reductions.
The program aligns with industry trends emphasizing value-based care and population health management, reinforcing payer-provider collaboration. By embedding clinicians in hospital settings, Aetna advances care continuity, which is crucial in managing the complex needs of the aging Medicare population. This initiative reflects growing insurer investments in innovative care coordination models to address utilization and improve patient outcomes within Medicare Advantage frameworks.