Aetna Program Has Helped Physicians over 350,000 Times; MedQuery Program Finds Care Improvement Opportunities Not Likely to Be Discovered From Paper Medical Records.

HARTFORD, Conn. -- Aetna's (NYSE:AET) national MedQuery(SM) program has detected over 350,000 opportunities to improve clinical quality and patient safety. Through the program, Aetna converts member health data into practical, usable information and provides it to treating physicians who can use it to improve care and patient safety. Aetna has nearly 3.5 million members in the program.

"As medical care becomes more and more complex, with patients managed by multiple specialists, it is more important than ever to make use of computerized systems to identify opportunities to improve care and prevent error," said William C. Popik, M.D., Aetna's Chief Medical Officer. "While all treatment decisions are ultimately the responsibility of the physician in consultation with their patient - and based on the unique circumstances of that patient - MedQuery is a valuable resource because it enables physicians to improve aspects of a patient's care that might otherwise not have been detected."

How Does MedQuery Work?

Through the MedQuery program, Aetna's data is analyzed and the resulting information gives physicians access to a broader view of a patient's clinical profile. Data reviewed include: claims history, current medical claims, pharmacy, physician encounter reports, laboratory reports, and patient demographics.

On a weekly basis, this data is compared against thousands of evidence-based care guidelines that have been adopted within the medical community as the standard of care. The comparison unearths gaps in care, medical errors, and deviations from evidence-based clinical guidelines. It also can alert a physician when a necessary and prescribed medication has not been filled.

For example, claim data might show that a member had a heart attack, but has not filled a prescription for a beta blocker medication, which is the accepted best practice to reduce the risk of a future heart attack. Or, a member might have had lab work ordered by one physician which shows deteriorating kidney function, while a second physician treating the patient for a separate condition might have unknowingly prescribed a medication which could damage the kidneys further.

When MedQuery identifies a patient whose data indicates that care may not be in conformance with certain best-practice protocols - a "care consideration" - a clinician contacts the treating physician via a telephone call, fax or letter based on the urgency of the situation. All privacy guidelines related to the management, security and privacy of patient information are followed throughout the process. Armed with the broader profile Aetna has provided, the treating physician is empowered with information he or she can use to contact the patient and adjust a treatment plan and possibly prevent a serious adverse event.

Physician Feedback

To date, physician feedback to Aetna has been overwhelmingly positive, with numerous physicians asserting via survey responses or telephone calls that the information they receive through this program is timely, credible, and "actionable," meaning they can use it to make a difference in patient care quality.

"The number, volume and motivation of competing sources of information can often make it difficult to separate the wheat from the chaff, to determine and implement best practice guidelines," said Joel Steinberg, M.D., Ph.D., F.A.C.A., of The Circulation Care/ Vein Center(R) in Philadelphia, Pennsylvania. "Reminders such as these can help facilitate more uniform implementation of evidence based medicine. They are presented in a clear fashion, with appropriate links to credible clinical studies, and can therefore have a practical, meaningful impact on patient care."

MedQuery's Growth and Value

Aetna is the first national health plan to offer the MedQuery program, made possible through a national relationship with ActiveHealth Management, Inc. Aetna selected ActiveHealth Management based on its industry leadership in applying evidence-based medicine to managed care data bases to promote clinical excellence. The program was launched in October 2002, for 165,000 Aetna members and has grown to nearly 3.5 million members as of February 2005.

Aetna studies show that plan sponsors who purchase the MedQuery program see an average return on investment of two to one, meaning that for every $1 spent on the program $2 of medical cost savings is realized through avoided complications and medical errors and ineffective treatments. Savings generally are higher for customers who have both medical and pharmacy benefits with Aetna, which creates a more robust, integrated data set. Savings also are higher among older employee/membership populations, where the illness burden typically is greater.

As further testament to the program's benefits, effective this year, Aetna is offering the MedQuery program to new and renewing fully-insured customers who offer Aetna's integrated medical and pharmacy benefits for portions of their insured populations.

In addition, Aetna is systematically incorporating selected categories of care considerations into our internal patient management system to keep Aetna's nurse case managers aware of opportunities that may have arisen on cases they are managing.

As one of the nation's leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 13.7 million medical members, 11.9 million dental members, 8.4 million pharmacy members and 13.5 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 655,000 health care professionals, including over 390,000 primary care and specialist doctors and 3,937 hospitals. For more information, please visit www.aetna.com. (Figures as of December 31, 2004)