Aetna Expands Hospital Collaboration Program to Reduce Medicare Readmissions

CVS Health's Aetna has announced the expansion of its Aetna Clinical Collaboration (ACC) program to be implemented in ten hospitals by the end of 2025. This program embeds Aetna nurses within hospital staff to support Medicare Advantage members during hospital discharge and care transitions, a crucial period for patient outcomes and readmission risks.

The initiative aims to reduce 30-day hospital readmission rates and hospital length of stay by 5% year-over-year, addressing a significant challenge as nearly 20% of Medicare patients face readmission within 30 days of discharge. Early results from the program indicate that around 25% of participating members are actively engaged with Aetna care managers, aligning with industry standards for care management adoption. The ACC program represents a strategic integration of insurer and provider efforts, aiming to bridge gaps in patient care during transitions from hospital to home or skilled nursing facilities. This approach supports value-based care principles and could lead to substantial cost savings; preventing readmissions can save between $15,000 and $20,000 per instance. Aetna, serving over 4 million Medicare Advantage members, plans to continue expanding the program through 2026 and extend it into its Commercial business lines. The program also seeks to reduce the administrative burden on hospital staff by closely collaborating with providers at discharge points.

This initiative is part of CVS Health's broader commitment to personalized, technology-driven health services designed to improve access, quality, outcomes, and cost-efficiency for insured populations. The ACC program's expansion involves well-established partners including AdventHealth Shawnee Mission, Houston Methodist, and WakeMed Health & Hospitals.

The effort highlights ongoing industry trends toward payer-provider collaboration and integrated care models to manage high-cost, high-risk populations like Medicare Advantage beneficiaries. Given the financial and health impacts of hospital readmissions, the ACC program is positioned to influence payer strategies and care coordination best practices extensively across the U.S. healthcare system.