Payers

Aetna, McLaren Physician Partners collaborate to extend coverage in Michigan

The health insurer and Michigan-based physician organization are partnering to expand access to in-network care for around 40,000 individual and group Medicare Advantage plan members. The partnership will go into effect Dec. 1.

Health insurer Aetna is collaborating with McLaren Physician Partners to allow its Medicare Advantage members in-network access to the care network based in Michigan and Ohio.

Aetna’s Medicare Advantage membership has grown nearly three-fold in three years within Michigan, Gregg Kimmer, Aetna’s chief Medicare officer, Great Lakes, said in an email. The new partnership will give the expanded membership access to 15 hospitals and three non-hospital subsidiaries, as well as about 900 employed primary and specialty care providers that are a part of McLaren Physician Partners.

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Both individual and group Medicare Advantage plan members — about 40,000 in all — will gain access to the care network once the partnership agreement takes effect Dec. 1.

“From our view, this partnership represents a very exciting opportunity to unite with a top-tier health system,” Kimmer said. “Their presence and ability to serve the various communities in Michigan will help enable best-in-class healthcare for the thousands of Aetna Medicare members in the state.”

McLaren Physician Partners, a physician organization, is part of McLaren Health Care headquartered in Grand Blanc, Michigan. The $6 billion healthcare system, which also operates in Ohio, includes ambulatory surgery centers, imaging centers, pharmacy services and a clinical laboratory network in addition to hospitals and the physician organization.

“This new partnership with Aetna, one of the largest and most recognizable names in health insurance products and services, allows McLaren Physician Partners to expand its reach in Michigan and Ohio and provide patient-focused healthcare services to those consumers who place their trust in the Aetna brand,” said Gary Wentzloff, president and CEO of McLaren Physician Partners in a news release.

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Aetna currently offers Medicare Advantage plans to around 82% of all eligible beneficiaries in Illinois, Michigan, Indiana and Wisconsin.

“We couldn’t be happier with this, but the imperative now becomes product expansion within those geographies,” Kimmer said.

Aetna recently launched a new Dual Eligible Special Needs Plan in Detroit for 2021. Insurers can design these plans, which are a type of Medicare Advantage prescription drug plan, for beneficiaries who are eligible for both Medicaid and Medicare. Generally, these plans limit costs for members who are eligible to enroll in them, Kimmer said.

“Maintaining this aggressive growth trajectory requires provider relationships with great partners. For this reason, we feel our new relationship with McLaren represents a unique opportunity to serve a much broader number of members than ever before,” he said.

Looking ahead, Aetna is focused on expanding the types of member benefits they offer, including increasing social determinants of health offerings.

Photo: mediaphotos, Getty Images