Cigna Continues Expansion of Collaborative Accountable Care to Improve Health and Lower Costs
-Program expands to Maryland, Washington state, southern 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 clinical care coordinators aligned to Cigna case managers
BLOOMFIELD, Conn.,- Cigna continues to expand its collaborative accountable care (CAC) program through seven new initiatives with physician groups in eight states, including the company’s first CACs in Maryland, Washington state and southern California. With the addition of these initiatives, Cigna now has 58 collaborative accountable care programs in 24 states covering more than 650,000 customers, and remains on track to reach its goal of 100 initiatives for one million customers in 2014. Cigna launched its first collaborative accountable care program in 2008.
These programs focus on improving patient access to health care, enhancing care coordination, and achieving the “triple aim” of improved health, affordability and patient experience. 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.
As of April 1, the newest members of Cigna’s network of collaborative accountable care initiatives are:
In California: HealthCare Partners Medical Group, a network of primary care physicians and specialists with medical clinics throughout the Los Angeles Metro area. http://www.healthcarepartners.com
In Maryland: Greater Baltimore Health Alliance, an Accountable Care Organization of employed and community based providers, serving Central Maryland. http://www.gbha.org
In Missouri: Meritas Health, a physician network affiliated with North Kansas City Hospital. www.nkch.org
In New Jersey: Atlantic Accountable Care Organization, one of the largest and first-approved ACOs in the nation. Its provider network includes: Atlantic Health System’s Morristown, Overlook, and Newton Medical Centers. With more than 1,300 physicians, the ACO cares for more than 55,000 Medicare beneficiaries throughout Northern New Jersey. www.atlanticaco.org.
In North Carolina and South Carolina: Novant Health, an integrated system of hospitals and physician practices in Charlotte, the Triad area, Brunswick County (N.C.) and upstate South Carolina. http://www.novanthealth.org
In Ohio: Cleveland Clinic, a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. http://my.clevelandclinic.org
In Washington: Northwest Physicians Network, a multispecialty independent physician association (IPA) serving the south Puget Sound area. http://www.npnwa.net/
“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 support 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 value” 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 650,000 Cigna customers and more than 23,000 doctors, including more than 11,000 primary care physicians and more than 11,500 specialists.
Cigna Corporation (NYSE: 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 78 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
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