Photo–Michelle Sweet (back to camera) talks with Dr. Mark Friedlander, Chief Medical Officer, and Cara McNulty, Vice President of Aetna Behavioral Health. (Photos courtesy of Aetna)
Our residential treatment facility is in rural Central Texas, but La Hacienda’s professional staff ranges far and wide to network with industry professionals and gather resources that help us provide top care.
That’s why Senior Utilization Review Specialist Michelle Sweet was in Hartford, Connecticut, recently, attending Aetna’s 2019 Behavioral Health Summit. She was one of only two representatives from treatment centers nationwide at the event.
“They are doing very innovative things,” says Michelle, who works to obtain adequate insurance coverage for patients. “Aetna is trying to be different, to offer a more holistic approach to improving their members’ health.”
Institutes of Quality
La Hacienda already has a unique relationship with the insurance company. It was one of the charter members of Aetna 360 Behavioral Health Institutes of Quality program started in 2018.
Under the program, in which there are 20 approved providers nationally, once Aetna initially approves treatment for a patient, no further authorizations are needed.
“They’ve already vetted La Hacienda as a treatment center that provides quality care,” says Michelle. “They trust us. They’re not going to waste resources paying someone to continue watch what we’re doing for a patient.”
“We have a dedicated contact. When a patient has Aetna insurance, we tell the contact, and they line up the patient’s coverage, including social services for family during treatment and post-treatment peer counseling.”
“Aetna takes great care of their patients, and they take care of La Hacienda and other providers.”
CVS Health Plans
The health summit also gave Michelle an inside look at plans CVS Health has in the wake of its 2018 acquisition of Aetna.
“I had lots of one-on-one interaction with their leaders, including a fireside chat with Karen Lynch, Executive Vice President of CVS Health, and Cara McNulty, President of Aetna’s Business Unit. I learned a great deal about their plans and programs. I was also able to answer questions they had about La Hacienda.”
One of CVS Health’s proposals is a unique partnering of its stores and insurance division.
“They want to put mini-clinics in every CVS store,” she says. “In addition to getting a flu shot, you could also see a therapist, say you have a substance use problem, and they would give you a referral—through Aetna insurance—with a treatment provider.”
“It would be new-age access to health care,” says Michelle.