Aetna Premier Care Network Plus Performance Study

This report presents a comprehensive analysis of the Aetna Premier Care Network Plus (APCN+) and its effectiveness in managing healthcare costs while maintaining quality of care. The study utilizes a matched-cohort methodology to compare approximately 13,000 members enrolled in APCN+ with nearly 40,000 members from a control group over a span of up to four years. Key findings indicate a significant 14% decrease in medical cost trends in the first two years post-enrollment, translating to an average savings of $37 per member per month. The analysis highlights reductions in hospital admissions and improved utilization of urgent care services. Notably, the study reveals that members adapted their healthcare-seeking behavior over time, leading to increased in-network visits. The findings suggest that APCN+ effectively combines cost savings with quality care, providing evidence that performance networks can deliver on their promises. This report serves as a valuable resource for plan sponsors considering narrow network health plans.