Aetna Announces Comprehensive Program to Address End-of-Life Care Issues for Members

[Aetna via BizWire]

Aetna Announces Comprehensive Program to Address End-of-Life Care Issues for Members; Program provides expanded benefits, support services and information
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HARTFORD, Conn.--(BUSINESS WIRE)--April 29, 2004--Aetna (NYSE:AET)
today announced a comprehensive new program of expanded benefits,
nurse case management and information to help members and their
families cope more effectively with the complex and emotional issues
involved in care at the end of life. The program also provides tools
and information to encourage advance planning for the kind of issues
often associated with end-of-life care.
The industry-leading benefits package, which will be available to
a number of large customers in January 2005, includes broadened
coverage for hospice and palliative services and provides coverage for
curative care while in hospice. Additionally, the program provides
coverage for respite care and bereavement care services.
"Today, our health care system is failing to meet the needs of the
dying, which can include pain and symptom management, help in
achieving a sense of control, and support for the emotional and
spiritual needs of both patients and their caregivers," said John W.
Rowe, M.D., Aetna chairman and CEO.
"Too often, people are unaware that they have choices when they
are in advanced stages of a disease. This program allows people to
continue to get the medical treatment that they and their physicians
believe is important while enabling patients to achieve the commonly
voiced objective of dying with dignity, in a place where they are
comfortable, with those whom they love most. We want people to know
their options and feel empowered to make meaningful decisions in
concert with their family and physicians.
"We're launching this program because it is the right thing to
do," Rowe said. "It's not about reducing medical costs or saving
money. It's about giving people choices and autonomy in the care they
receive at the end of their lives. We worked with a team of highly
respected thought leaders to develop an innovative, best-in-class
program, and as a geriatrician, I am extremely proud to offer it to
our customers and members."
The company will offer the new Aetna Compassionate Care(SM)
program to several large plan sponsors representing more than 400,000
members beginning in January 2005. Aetna will work closely with these
customers to study the program's effectiveness, costs, clinical
outcomes and communications challenges, and will use the experience to
support evidence-based decisions on how to improve the program and
broaden its availability in the future.
"This program provides an opportunity for us to provide additional
services and benefits to our employees coping with the complex and
emotional issues associated with care at the end of life, as well as
to gain a deeper understanding of how we can support improvements in
the quality of care our employees and their families receive," said
David Kostelanksy, Corporate Director, Human Resources & Benefits, FMC
Technologies. "We often find that employees don't have access to the
kinds of information they need to make informed decisions, so we're
pleased that a component of the program involves accessible and
easy-to-understand tools and information."
"Aetna has demonstrated a commitment to raising the bar on the
quality of care near the end of life for Americans. By launching its
Compassionate Care program, Aetna has taken a leadership position in
addressing one of the major gaps in our health care system in a manner
that is easily accessible and culturally sensitive," said Karen
Kaplan, M.P.H., Sc.D., president and CEO of Last Acts Partnership.
"The company has launched this program because its leaders believe
deeply that it is the right thing to do, and we applaud that approach
to health care."

The Aetna Compassionate Care program has three key components:

-- Expanded benefits. Members whose plan sponsors provide the
Aetna Compassionate Care program as part of their benefit
package will be eligible for these benefits, which are in
addition to traditional hospice services, when their doctor
certifies that there is a likelihood of death over the next 12
months.

-- Coverage for curative care while in hospice.
Traditionally, entry into a hospice program has been
premised on two key requirements that have been
significant barriers to entry: a doctor's certification of
the likelihood that the patient will die in six months,
and the patient agreeing to forego further curative
treatments. To maximize the valuable benefit of hospice
services, Aetna is broadening the opportunity to enter
into hospice services for people with a life expectancy of
approximately 12 months. In addition, members will not be
precluded from continuing to seek curative care at any
point while in the program.

-- Respite Care services. Caregivers can benefit from taking
a break from the daily routine of caring for a very ill
person. Respite care is short-term, temporary care for
patients with complex, often terminal illnesses that is
designed to give their caregivers the rest or "respite,"
they need. Aetna's Compassionate Care program provides
coverage for up to 360 hours of respite care.

-- Bereavement care services. Grief counseling is also a
component of the program, available to the Aetna member
who has experienced the death of a family member or friend
and feels the need for this support. Aetna's Compassionate
Care program provides coverage for up to 12 months of
bereavement care services.

-- Case management services. Aetna's nurse case managers have
long provided end-of-life care coordination as part of their
responsibilities. However, our vision for the Compassionate
Care program takes these capabilities to the next level.

-- A comprehensive training program, under way now, will make
supporting these members a core competency among Aetna's
385 nurse case managers.

-- The nurses are being fully trained to assess and manage
members' care in a culturally sensitive manner, helping to
improve pain and other symptom management, improve
continuity of care, improve advance care planning, expand
personal support, and encourage better use of
community-based services and resources.

-- To develop and deliver this training, Aetna has worked
with the National Hospice and Palliative Care
Organization, America's oldest and largest nonprofit
membership organization representing hospice and
palliative care programs and professionals across the
country. These enhanced case management services will be
immediately available to all Aetna members.

-- Information and tools. User-friendly, culturally sensitive and
easily accessible decision support tools and information for
consumers regarding palliative care and end-of-life care have
not been widely available. Aetna's Web-based "resource center"
at www.aetna.com or directly at
www.aetnacompassionatecareprogram.com, features:

-- General information on end-of-life and palliative care
issues

-- Advance planning tools

-- Discussion tips to facilitate conversations

-- Advance directives forms

-- Living wills and much more

In addition, for members in the program who do not have Web
capabilities, the information will be available by mail.

Research supports the need for attention and focus on matters
associated with end-of-life care, including these findings:

-- Nationally, only 25 percent of deaths occur at home, although
more than 70 percent of Americans say that this is where they
would prefer to die (Robert Wood Johnson Foundation)

-- Many people dying in institutions have unmet needs for symptom
amelioration, physician communication, emotional support, and
being treated with respect (Journal of the American Medical
Association, 2004)

-- Experts agree that patients need at least 60 days of hospice
care to maximize its benefits; however, the median length of
stay for hospice patients was 20.5 days in 2001 (National
Hospice and Palliative Care Organization)

-- Medical experts agree that at least 90 percent to 95 percent
of all serious pain can be safely and effectively treated, yet
at least half of all dying patients report being in pain
(Journal of Pain and Symptom Management, 1996)

Aetna is one of the nation's leading providers of health care,
dental, pharmacy, group life, disability and long-term care benefits,
serving approximately 13.3 million medical members, 11.2 million
dental members, 8.1 million pharmacy members and 12.4 million group
insurance customers, as of March 31, 2004. The company has extensive
nationwide networks of more than 618,000 health care services
providers, including over 370,000 primary care and specialist
physicians and 3,783 hospitals. For more information about Aetna,
please visit the company's web site at www.aetna.com.