Profession

Aetna settlement foundation hands out grants

The organization dedicated to small and solo physician groups awarded money to proposals tackling issues of chronic illness management, care for the uninsured and technology.

By Mike Norbut — Posted Dec. 12, 2005

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The foundation established as part of physicians' settlement of a class action against insurance giant Aetna Inc. has awarded about $16 million to physician groups in its inaugural grant cycle.

The grants, which are designed to benefit small and solo practices, were awarded to proposals for programs that sought to help patients with chronic illnesses, upgrade technology to improve patient safety, and treat uninsured patients.

More than 400 organizations submitted proposals, and 26 received grants that ranged from nearly $100,000 to $1 million. Foundation leaders said it was yet another positive outcome of the years doctors spent fighting insurance companies over reimbursement.

"Put it this way: We're very proud to be able to do this and we expect in the next year, we'll be able to do it again," said Tim Norbeck, executive director of the Connecticut State Medical Society and president of the Physicians' Foundation for Health Systems Excellence.

The foundation, which has nearly $100 million in assets, was set up as part of physicians' agreement with Aetna. The insurer gave the foundation $20 million as part of the settlement. The remainder was from physicians who donated their individual portions of the settlement.

Aetna was the first company to settle physician claims that HMOs conspired to systematically underpay doctors by downcoding and bundling claims. Of the 10 original defendants, six additional companies have settled: Cigna Healthcare, Health Net, Humana Inc., Prudential Insurance Co. of America, WellPoint (including claims against WellPoint Health Networks) and Anthem.

Only Coventry, PacifiCare Health System and UnitedHealthcare -- the latter two of which have announced plans to merge -- have not settled. A trial is set to begin Jan. 23, 2006.

Many of the foundation grants were awarded to larger nonprofit organizations that proposed to conduct research on an issue that could benefit the greater physician community, said Lou Goodman, PhD, CEO of the Texas Medical Assn. and chair of the foundation's Grants Committee.

"We wanted research to benefit small and solo groups, and we wanted results that would be transportable," he said. "We want to put all the results on a Web site and widely disseminate it."

A second foundation, Physicians' Foundation for Health Systems Innovations, was created from doctors' settlement with Cigna. It has about $16 million in assets, and plans to award a sizeable grant to a cornerstone program that can help physicians adapt to the ever-changing information technology arena, Dr. Goodman said. Members of that foundation plan to wait for more clarity from the federal government regarding health care information technology issues to decide what the proper program should be, he said.

Information about the foundations and grant cycles is online (link).

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ADDITIONAL INFORMATION

The winners are

The top grant recipients, in terms of financial awards, from the Physicians' Foundation for Health Systems Excellence.

  • Middlesex Professional Services Foundation, Middletown, Conn.; Clinical Integration Project (chronic disease management), $1 million over two years
  • North Carolina Medical Society Foundation, Raleigh; Sustainable Practice Management & Development Project (access to care), $1 million over three years
  • Texas Medical Assn. Special Funds Foundation, Austin; Ensuring Patient Safety through Health Information Technology (technology), $1 million over two years
  • Washington State Education and Research Foundation, Seattle; Washington State Support for Quality Project (technology), $1 million over two years
  • American College of Physicians, Washington, D.C.; Center for Practice Innovation (quality of care), $996,000 over two years
  • Dallas Academy of Medicine; PracticeNet Solutions (care for the uninsured), $986,529 over one year
  • Patient Safety Institute, Plano, Texas; Real-Time Clinical Information for Physicians (technology), $985,000 over one year
  • Hawaii Medical Foundation, Honolulu; Bridging the Adoption Gap (technology), $900,000 over three years
  • Institute of Medicine & Public Health of New Jersey, Lawrenceville; Electronic Feedback for Physician Management of Chronic Care (chronic disease management), $878,651 over two years
  • Genesee Valley Medical Foundation, Rochester, N.Y.; Transforming Primary Care Office Practices (quality of care), $850,000 over two years

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