Aetna and Carolinas HealthCare System (CHC) entered into a collaboration in April 2013 in which they began using a “clinically integrated organization model to support stronger patient-centered medical homes and other accountable care efforts” to give Charlotte-area employers better health care options for their employees.17 Carolinas HealthCare System serves more than 20,000 patients in the Charlotte area who have Aetna coverage. Although the arrangement between CHC and Aetna was initially established with self-insured customers in mind, it has since become available to fully insured customers.

CHC is the largest health care system in the Carolinas and one of the country’s largest public systems. As of July 2015, it had more than 60,000 employees and more than 2,300 physicians, and it owned, leased or managed 39 hospitals for a total 7,640 beds in the Carolinas. Its network comprises nearly 800 care locations, including academic medical centers, hospitals, physician practices, home health agencies, surgical and rehabilitation centers, hospice and other providers.

CHC has maintained that nurse practitioners and physician assistants play a crucial role in an accountable care era, particularly with a shortage of primary care physicians and an aging population. It recently launched its Center for Advanced Practice, a transition-to-practice fellowship program for advanced care practitioners. Fellows are selected for the 12-month program and are paid a $60,000 stipend. Upon graduation, if hired by the system, they receive a $20,000 retention bonus. According to CHC, the program has improved clinical outcomes, enhanced physician and patient satisfaction, reduced turnover and lower recruitment costs.

The system is known for leadership in its IT infrastructure—particularly for its ambulatory EHR integration—having earned HIMMS Stage 7 Ambulatory Award for 230 of its clinic locations. Only 6 percent of ambulatory clinics nationwide have reached Stage 7 performance.

CHC has consistently made the Forbes list of America’s 500 best employers, most recently ranked #89.

CHC has 77 patient-centered medical homes, all accredited by the National Committee for Quality Assurance.

In the first quarter of 2015, operating income surged to $71.6 million, up from $10.5 million in the first quarter of 2014. Net operating revenue was $2.2 billion, up from $2 billion in 2014. CEO Michael Tarwater said gains in market share and a prolonged flu season contributed to first quarter growth.

Tarwater, who has led the system since 2002, announced plans to retire in June 2016.

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