NYUPN Clinically Integrated Network, LLC and Cigna Start Accountable Care Program to Improve Health and Lower Costs
• Consumers benefit from improved care coordination and greater emphasis on providing preventive care
• Primary care doctors are rewarded for improving patient health and lowering medical costs
• NYU Langone nurse care coordinators align with Cigna case managers to ensure a high degree of collaboration between NYUPN and Cigna
• NYUPN Clinically Integrated Network, LLC is a partnership between NYU Langone Medical Center and the University Physicians Network
NEW YORK & BLOOMFIELD, Conn. - Cigna (NYSE: CI) and NYUPN Clinically Integrated Network, LLC, an organization comprising all clinical faculty affiliated with NYU Langone Medical Center and the University Physicians Network (UPN), have launched a collaborative accountable care initiative to improve patient access to health care and enhance care coordination. The program is effective July 1, 2013.
The Collaborative accountable care initiative is Cigna’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The initiative is designed to deliver the right care, at the right time, in the right place, and reward health care professionals for achieving the “triple aim” of improved health, affordability, and patient experience. The program will benefit more than 24,000 individuals covered by a Cigna health plan who receive care from more than 300 NYUPN primary care physicians.
“We are thrilled to partner with Cigna on the collaborative accountable care initiative,” said Gary Kalkut, M.D., MPH, senior vice president of network integration and associate chief clinical officer at NYU Langone Medical Center. “NYU Langone is committed to providing its patients with world-class care. We believe this collaboration presents an opportunity for our Clinically Integrated Network to coordinate care that improves outcomes, reduces costs, and enhances the patient experience across the continuum of care.”
According to Paula Marchetta, M.D., M.B.A., president of NYUPN, “The Cigna contract is our first step toward realizing the vision of the Clinically Integrated Network at NYU Langone: To set the standard for high quality, cost-efficient care of our patients. Key to the success of the CIN is the creation of a true sense of cohesiveness – not just between the hospital and our many physicians, but also with our patients"
“We want to fundamentally change the health care delivery system by rewarding physicians for results,” said Dan Nicoll, M.D., Cigna’s senior medical director for New York. “A patient-centered system that’s focused on prevention and wellness, combined with the right incentives for physicians, will ultimately result in a healthier population and lower medical costs. That’s good for individuals, families, employers and doctors.”
Under the program, NYUPN monitors and coordinates all aspects of an individual’s medical care, both in and out of the hospital. Individuals most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease. Cigna customers whose physician is in the NYUPN will automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and choose to seek care from an NYUPN doctor can also access the program. There are no changes in plan requirements regarding referrals to specialists.
Critical to the program’s benefits are NYU Langone Medical Center employed registered nurses who serve as embedded care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between NYUPN and Cigna, providing a better experience for the individual. They are part of a physician-led care team that helps patients get the primary and specialty care they need, identifies potential complications related to medications, and manages chronic conditions to improve outcomes and reduce costs. The care coordinators use patient-specific data from Cigna to identify patients discharged from the hospital who may be at risk for readmission, as well as those who may be overdue for important health screenings or may need help managing their medications.
Care coordinators can 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 NYUPN for the medical and care coordination services it provides. Additionally, if NYUPN meets targets for improving quality and lowering medical costs, it can also earn shared savings.
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. Effective July 1, Cigna will have 66 collaborative accountable care initiatives in 26 states, encompassing more than 700,000 commercial customers and more than 27,000 doctors, including more than 12,500 primary care physicians and nearly 14,500 specialists. Cigna launched its first collaborative accountable care program in 2008 and its goal is to have 100 of them in place with one million customers in 2014.
Collaborative accountable care is one component of the company’s approach to physician engagement for health improvement, which also includes Cigna-HealthSpring’s care model for Medicare customers. Taken together, these 231 programs in 31 states reach more than one million customers and have nearly 55,000 participating doctors, including nearly 19,000 primary care physicians and nearly 36,000 specialists.
About NYUPN Clinically Integrated Network, LLC
NYUPN is the clinically integrated network (CIN) of University Physicians Network (UPN) and NYU Langone Medical Center (NYU Langone). This unique alignment brings together 1600 physicians of the UPN and NYU Langone hospitals to collaborate in implementing nationally recognized standards for patient-centered, high quality, cost-efficient healthcare delivery. All physicians and hospitals use electronic medical records (EMR) that are connected to a network wide health information exchange (HIE), facilitating timely exchange of clinical information. NYUPN will also serve as a vehicle to negotiate and successfully execute health care contracts based on new and emerging payment models that reward high quality and cost-efficient care.
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 80 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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