Aetna Expands Clinical Collaboration Program to Enhance Support for Hospitals and Provide Personalized Member Care

Rhea-AI Summary

CVS Health's Aetna (NYSE: CVS) announced the expansion of its Aetna Clinical Collaboration (ACC) program, which will be implemented in ten hospitals by the end of 2025. The program embeds Aetna nurses within hospital staff to support Medicare Advantage members during their hospital discharge and transition process.

The initiative, which has already shown promising results with 25% of program members actively engaged with an Aetna care manager, aims to reduce 30-day readmission rates and hospital length of stay by 5% year-over-year. The program is particularly significant as nearly 20% of Medicare-insured patients face hospital readmission within 30 days of discharge.

Positive

• None.

Negative

• Current high readmission rate of 20% among Medicare-insured patients indicates significant challenges
• Limited initial rollout to only 10 hospitals in 2025 compared to Aetna's large member base of 4+ million

Insights

Healthcare Strategist

Aetna's hospital collaboration program shows promising early results and expansion plans, potentially reducing readmissions and costs for Medicare Advantage business.

Aetna's Clinical Collaboration Program represents a strategic approach to addressing a significant healthcare challenge - the 20% of Medicare patients who are readmitted within 30 days of discharge. By embedding Aetna nurses directly within hospital settings, the company is creating an integrated care model that bridges the traditional gap between insurers and providers.

The program's targeted 5% reduction in year-over-year 30-day readmissions and hospital length of stay is particularly significant. For context, readmissions are extremely costly for both healthcare systems and insurers, with each prevented readmission potentially saving $15,000-$20,000. With Aetna serving over 4 million Medicare Advantage members, even modest percentage improvements translate to substantial financial impact.

The early engagement metric - approximately 25% of eligible members actively working with an Aetna care manager - suggests promising adoption. Successful care management programs typically achieve 20-30% engagement rates in their initial phases, placing Aetna's early results in line with industry benchmarks.

Strategically, this initiative aligns with broader industry trends toward value-based care and payer-provider collaboration. It addresses a key vulnerability in the healthcare journey while simultaneously reducing administrative burden on hospital partners. The planned expansion to Commercial business indicates confidence in the model's effectiveness and suggests potential for broader implementation across CVS Health's diversified healthcare operations.

• Aetna Clinical Collaboration Program on-track to implement in ten hospitals by end of 2025
• Early indicators show high member engagement with program projected to reduce 30-day readmissions and length of hospital stay

HARTFORD, Conn., Sept. 22, 2025 /PRNewswire/ -- Aetna^®, a CVS Health^® company (NYSE: CVS), today announced it will scale the Aetna Clinical Collaboration (ACC) program to ten hospitals by year-end, with implementations underway with AdventHealth Shawnee Mission, Houston Methodist and WakeMed Health & Hospitals. The ACC program brings Aetna nurses together with hospital staff, working side-by-side to help Medicare Advantage members get the care and support they need to remain healthy when they return home from the hospital or make the transition into a skilled nursing facility.

Hospital re-admissions happen more often among older populations, with nearly 20 percent of Medicare-insured patients who are hospitalized being readmitted within 30 days of being discharged.* The ACC program aims to improve care outcomes for Aetna Medicare Advantage members, reducing their 30-day readmission rates and emergency room visits while also easing the administrative load on hospitals and clinical personnel.

"Hospital discharge is one the most important—and vulnerable—moments in a patient's journey," said Dr. Ben Kornitzer, Senior Vice President and Aetna Chief Medical Officer. "Patients may be managing new diagnoses, complex medications, and follow-up needs, all while coping with the stress of transitioning back home or to a new facility. By embedding Aetna nurses within hospitals, we're partnering with care teams to ensure that members are supported every step of the way and have the right services to stay well and avoid complications that could lead to readmission."

The first ACC program was implemented earlier this year, with approximately 1 in 4 program members already actively engaged with an Aetna care manager. Once fully implemented at scale, the ACC program is projected to reduce year-over-year 30-day readmissions and hospital length of stay by five percent.

As a leading Medicare Advantage health plan provider, Aetna has more than 4 million members over 65 and plans to continue expanding the ACC program across its network in 2026 and beyond. The company is also implementing ACC for its Commercial business.

*Jencks, S., Williams, M. & Coleman, E. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine. 360(14),1418-28.

About Aetna

Aetna, a CVS Health business, serves an estimated 36 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care professionals, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).

About CVS Health

CVS Health is a leading health solutions company building a world of health around every consumer, wherever they are. As of June 30, 2025, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics, a leading pharmacy benefits manager with approximately 87 million plan members, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.

Media contact

Phil Blando
Phillip.blando@cvshealth.com

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SOURCE CVS Health

FAQ

What is Aetna's Clinical Collaboration (ACC) program and how does it work?

The ACC program embeds Aetna nurses within hospital staff to support Medicare Advantage members during hospital discharge and transition, helping reduce readmissions and improve care outcomes.

How many hospitals will implement CVS Health's Aetna Clinical Collaboration program by 2025?

Aetna plans to implement the ACC program in 10 hospitals by the end of 2025, including AdventHealth Shawnee Mission, Houston Methodist, and WakeMed Health & Hospitals.

What are the expected benefits of Aetna's ACC program?

The program is projected to reduce 30-day readmissions and hospital length of stay by 5% year-over-year, while also reducing administrative burden on hospital staff.

How successful has CVS Health's Aetna Clinical Collaboration program been so far?

Early indicators show strong engagement with approximately 25% of program members actively engaged with an Aetna care manager since the first implementation earlier in the year.

How many Medicare Advantage members does Aetna serve?

Aetna serves more than 4 million members over 65 through its Medicare Advantage health plans.