Cigna Continues Expansion of Collaborative Accountable Care to Improve Health Outcomes and Lower Cos
Cigna Continues Expansion of Collaborative Accountable Care to Improve Health Outcomes and Lower Costs
- Program expands to Florida, Indiana, Louisiana, South Carolina
- 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 clinical care coordinators aligned to Cigna case managers
BLOOMFIELD, Conn.--(BUSINESS WIRE)-- Cigna continues to expand its collaborative accountable care (CAC) program through 10 new initiatives with physician groups in nine states, including the company's first CACs in Florida, Indiana, Louisiana and South Carolina. With the addition of these initiatives, Cigna now has 52 collaborative accountable care programs in 22 states covering nearly 510,000 customers, and remains 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.
As of Jan. 1, the newest members of Cigna's network of collaborative accountable care initiatives are:
In Florida: BayCare Physician Partners, a clinically integrated physician network in the Tampa Bay area that's affiliated with BayCare Health System. http://www.baycarephysicianpartners.com/
In Florida: Orlando Health Physician Partners, the division that has oversight of the employed physicians activities within Orlando Health and which partners with like-minded health care providers to pursue collaboration, education and quality medicine. http://www.orlandohealthdocs.com/
In Indiana: Franciscan Alliance, a physician network in greater Indianapolis that's affiliated with Franciscan St. Francis Health. http://www.franciscanalliance.org
In Louisiana: Ochsner Clinic, a non-profit, academic, multi-specialty, health care delivery system serving New Orleans and Baton Rouge. http://www.ochsner.org/
In Maine: Central and Western Maine Regional PHO, a physician hospital organization in Lewiston, Farmington and other central Maine towns that's affiliated with Central Maine Health and Franklin Community Health Network. http://www.cmmf.org/ and http://www.fchn.org/fchn/pho/
In New Hampshire: Derry Medical Center, an independent family medical practice in Derry, Londonderry and Windham. http://www.derrymedicalcenter.com/
In New York: Mt. Kisco Medical Group, a multi-specialty medical group serving patients in 25 locations throughout Westchester, Putnam and Dutchess counties. http://www.mkmg.com/
In Ohio: Central Ohio Primary Care Physicians, one of the largest physician-owned primary care medical groups in the United States, serving Columbus and other central Ohio communities. http://www.copcp.com/
In South Carolina: Palmetto Primary Care Physicians, a primary and specialty care medical practice with more than 30 offices in Charleston and the TriCounty. http://www.palmettoprimarycare.com/
In Texas: Village Health Partners, a nationally-recognized primary care practice serving North Texas patients with two locations in Plano. http://www.villagehealthpartners.com/
"We're very selective when we choose physician groups to participate in our collaborative accountable care program," said Alan M. Muney, M.D., Cigna's chief medical officer. "We look for organizations that put the patient at the center of its practice and whose commitment to the triple aim starts with senior leadership and permeates the entire organization. These types of organizations offer the best opportunity to improve quality, cost and patient experience, to the benefit of our customers and clients."
"Employers bear a large part of the nation's health care costs, so they welcome innovations aimed at transforming our health care system from one that rewards doctors for volume of care to one that rewards them for improving the quality and value of care," said Helen Darling, president and chief executive officer of the National Business Group on Health. "Cigna continues to take important steps in that direction through the ongoing expansion of its collaborative accountable care program. I congratulate Cigna and these physician groups for their continued 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 CAC program's benefits are registered nurses or other clinicians, employed by the physician practices, who serve as 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 nearly 510,000 Cigna customers and more than 14,000 doctors, including more than 6,500 primary care physicians and more than 7,500 specialists.
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.
Mark Slitt, 860-226-2092
KEYWORDS: United States North America Connecticut
The article Cigna Continues Expansion of Collaborative Accountable Care 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 - 2013 The Motley Fool, LLC. All rights reserved. The Motley Fool has a disclosure policy.