Cigna Expands Collaborative Accountable Care Program to Improve Health Outcomes and Lower Costs
Program expands to Nevada and Oregon, grows in five other states including California
Consumers benefit from improved care coordination and greater emphasis on preventive care
Primary care doctors are rewarded for improving patient health and lowering medical costs
Program includes registered nurse clinical care coordinators aligned to Cigna case managers
BLOOMFIELD, Conn.--(BUSINESS WIRE)-- Cigna continues to expand its collaborative accountable care program through nine new initiatives with physician groups in seven states - Arizona, California, Colorado, Connecticut, Nevada, Oregon and Tennessee. With the addition of these initiatives, Cigna now has 42 collaborative accountable care programs in 18 states covering more than 390,000 customers, and is on track to reach its goal of 100 initiatives for one million customers by the end of 2014. Cigna launched its first collaborative accountable care program in 2008.
These programs focus on expanding patient access to health care, improving care coordination, and achieving the "triple aim" of improved health outcomes (quality), affordability and patient satisfaction. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs, with a strong focus on high-risk individuals, including people with chronic health conditions such as diabetes or heart disease.
In places where it's been introduced, collaborative accountable care is helping to improve the health of Cigna customers while holding the line on medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescriptions refills, and they're reducing unnecessary use of hospital emergency rooms, increasing the number preventive health visits and improving follow-up care for people transitioning from the hospital to home.
For example, in 2011, Medical Clinic of North Texas (MCNT) improved total medical cost trend by 4.4 percent while maintaining quality (as measured by following evidence-based medical guidelines) at four percent better than the North Texas market. During the same period, EMHS (Eastern Maine Healthcare Systems) maintained quality at five percent better than its market. Also in 2011, Holston Medical Group had an overall emergency room visit rate that was 12 percent lower than its Eastern Tennessee market, while avoidable emergency room visits for Cigna Medical Group were 24 percent lower than the Phoenix market.
Effective Oct. 1, unless otherwise noted, the newest members of Cigna's network of collaborative accountable care initiatives are:
In Arizona: Banner Health Network (effective Nov. 1), a nonprofit health system with operations throughout the West, including greater Phoenix. http://www.bannerhealth.com
In California: Brown & Toland Physicians, an independent practice association based in San Francisco. http://www.brownandtoland.com
In Colorado: iPN(The integrated Physician Network), a quality improvement collaborative that's affiliated with Colorado's largest not-for-profit health care system, Centura Health. http://www.ipn.org/
In Colorado: MedSouth, a multi-specialty, clinically integrated independent practice association located in the south metropolitan area of Denver.
In Connecticut: Day Kimball Healthcare and its affiliated physicians group, an integrated medical services network serving northeast Connecticut. http://www.daykimball.org/
In Connecticut: New Haven Community Medical Group, an integrated network of physicians and other health care professionals that works in clinical collaboration with the Yale-New Haven Hospital. http://www.ynhcmg.org
In Nevada: HealthCare Partners, a network of primary care physicians and specialists with medical clinics and specialty care affiliates throughout greater Las Vegas. http://www.hcpnv.com/index.php
In Tennessee: Synergy HealthCare LLC, an independent physician association managed by Tennessee Quest (a HealthSpring physician management company), serving Nashville and middle Tennessee.
In Oregon: Legacy Health, a community-owned health system in greater Portland. http://www.legacyhealth.org/
"Our collaborative accountable care programs continue to show improvements in quality and cost, to the benefit of our clients and customers, so we remain committed to our goal of 100 programs reaching one million individuals by the end of 2014," said Alan M. Muney, M.D., Cigna's chief medical officer. "We're very selective when we choose the physician groups to be part of this effort. These physician groups are committed to putting the patient at the center of its practice, with expanded access to care, better coordination of care, patient education about chronic conditions and wellness, access to clinical programs for health improvement, and smart use of technology that improves the patient experience."
"Employers bear such a large part of the nation's health care costs, and they're always looking for ways to transform our health care system from one that rewards doctors for volume of care to one that rewards them for improving quality and value of care. Cigna's collaborative accountable care program is taking an important step in that direction," said Helen Darling, president and chief executive officer of the National Business Group on Health. "I congratulate Cigna and these physician groups for their efforts to reshape health care in the U.S. and create a delivery system that works for patients, consumers, health care professionals and purchasers."
Critical to the programs' benefits are registered nurses, employed by the physician practices, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. Care coordinators from each physician practice are aligned to a team of Cigna case managers to ensure a high degree of collaboration between the medical group and Cigna that ultimately results in a better experience for the individual.
The care coordinators enhance care by using patient-specific data provided by Cigna to identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. Care coordinators contact these individuals to help them get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.
Care coordinators also help patients schedule appointments, provide health education and refer patients to Cigna's clinical programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.
Cigna will compensate physician groups for the medical and care coordination services they provide. The physician groups will also be rewarded through a "pay for performance" structure if they meet targets for improving quality and lowering medical costs.
The principles of the patient-centered medical home are the foundation of Cigna's collaborative accountable care initiatives. Cigna then builds on that foundation with a strong focus on collaboration and communication with physician practices. The initiatives encompass more than 390,000 Cigna customers and more than 5,500 primary care physicians.
Cigna Corporation (NYS: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has approximately 71 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
Photos/Multimedia Gallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50445374〈=en
Mark Slitt, 860-226-2092
KEYWORDS: United States North America Arizona California Colorado Connecticut Nevada Oregon Tennessee
The article Cigna Expands Collaborative Accountable Care Program to Improve Health Outcomes and Lower Costs originally appeared on Fool.com.
Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.
Copyright © 1995 - 2012 The Motley Fool, LLC. All rights reserved. The Motley Fool has a disclosure policy.