The California Department of Managed Health Care (DHMC) approved Aetna’s acquisition of Humana under these conditions:
- Aetna will keep premium rate increases to a minimum for HMO small group.
- The DMHC will have increased oversight on rates.
- Aetna will keep key functions and operations in the state, such as medical decision making and
- enrollee grievance and appeals systems.
- Aetna will improve quality of care measured through rating and oversight programs under the National Committee for Quality Assurance and Office of the Patient Advocate.
Over the next three years, Aetna will make several community investments to educate at-risk populations on their health care rights, increase access to care for low-income and underserved communities, and improve California’s health care infrastructure:
- $6 million to support consumer assistance programs to help seniors and people with disabilities understand their health care rights.
- $3 million to provide dental services in low-income and/or underserved communities and scholarships for dentists to be trained to serve young children (ages 0-3).
- $23 million to strengthen and support the health care industry in the economically distressed community of Fresno through the expansion of a service center.
- $1 million to expand telehealth services to increase access to mental health care and reduce unnecessary emergency room visits.
- $16.5 million in California’s health care infrastructure to support accountable care organizations and pay for performance programs.