ChoiceHealth and Cigna Start Collaborative Care Program
Improves Health and Lowers Costs for Northern Virginia Customers
Customers benefit from improved care coordination and greater emphasis on preventive care.
Doctors are rewarded for improving patient health and lowering medical costs.
Program includes registered nurse care coordinators aligned with Cigna case managers.
Cigna (NYSE: CI) and ChoiceHealth doctors in Virginia are launching a collaborative care initiative to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. ChoiceHealth, a subsidiary corporation of Novant Health will bring independent primary care providers that are part of the ChoiceHealth network and Novant Health Medical Group providers together for this program.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program, which will start on October 1, will benefit nearly 3,000 individuals covered by a Cigna health plan who receive care from over 35 primary care doctors who are part of ChoiceHealth in Virginia. Cigna now has five collaborative care arrangements in Virginia and 105 of them nationwide. In addition, Cigna has a collaborative care arrangement with Novant Health that serves its customers in the Carolinas.
In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reducing unnecessary use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.
“The Cigna Collaborative Care program only further supports what Novant Health is doing to create a new level of care coordination,” said Melissa Robson, president, Novant Health northern Virginia market. “This program aligns with our system’s desire to provide better care for individuals and populations while lowering the overall cost of care.”
“We need a patient-centered health care system that emphasizes prevention and primary care and rewards physicians for quality of care and improved health outcomes,” said Julia Huggins, president, Cigna Mid-Atlantic. “A system that’s focused on value rather than volume will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors.”
Under the program, physicians who are part of ChoiceHealth will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physician and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a ChoiceHealth doctor will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients who need help managing chronic conditions such as diabetes, heart disease and obesity are most likely to see the immediate benefits of the program.
Critical to the program’s benefits are the registered nurse clinical care coordinators, employed by ChoiceHealth, who will 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 ChoiceHealth physicians and Cigna, which will ultimately provide a better experience for the individual.
The care coordinators will enhance care by using patient-specific data from Cigna to help 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. The care coordinators are part of the physician-led care team that will help patients get the follow-up care or screenings they need, identify potential complications related to medications and help prevent chronic conditions from worsening.
Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna’s clinical support programs that may be available as part of their health plan, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs for quitting smoking or managing weight.
Cigna will compensate ChoiceHealth for the medical and care coordination services they and their physicians provide. Additionally, physicians may be rewarded through a “pay for value” structure for meeting targets for improving quality and lowering medical costs.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 105 Cigna Collaborative Care arrangements with large physician groups that span 27 states, reach more than 1.1 million commercial customers and encompass more than 41,000 doctors, including more than 20,000 primary care physicians and more than 20,000 specialists.
Cigna Collaborative Care is one component of the company’s approach to physician engagement for health improvement, which also includes the innovative Cigna-HealthSpring® care model for Medicare customers. Today, more than 1.4 million Cigna and Cigna-HealthSpring customers benefit from 270 engaged physician relationships across 31 states, with more than 68,000 doctors participating, including more than 26,000 primary care physicians and more than 41,000 specialists.
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