Baycare Health Partners and Cigna Start Accountable Care Program to Improve Health and Lower Costs
<0> CignaMark Slitt, 860-226-2092orBaycare Health PartnersDebra Cremonti, 413-794-9345 </0>
Cigna (NYSE:CI) and , a physician hospital organization (PHO) serving three counties in western Massachusetts, have launched a initiative to improve to health care, enhance , and achieve the “” of , and . The program is effective July 1.
is Cigna's approach to accomplishing the same population health goals as , or s. The program will benefit more than 17,000 individuals covered by a Cigna health plan who receive care from Baycare’s 413 primary care physicians. The program with Baycare is Cigna's first accountable care program in Massachusetts.
“Each and every day our doctors and clinical team come to work focused on providing well-coordinated care that helps our patients live healthier, more productive lives,” said Dr. Stephen J Sweet, chief executive officer of Baycare Health Partners. “Our commitment to quality care that delivers superior results for our patients is perfectly aligned with Cigna's commitment to changing the focus of health care from volume of care to quality and value of care.”
“We’re aiming to fundamentally change the health care delivery system by rewarding physicians for results,” said Robert Hockmuth, M.D., Cigna’s senior medical director for New England. “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, Baycare Health Partners monitors and coordinates all aspects of an individual’s medical care. Patients 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 doctor in the medical group will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease.
Critical to the program’s benefits are registered nurses, employed by Baycare Health Partners, who serve as clinical 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 the medical group and Cigna that ultimately results in 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 helps patients get the follow-up care or screenings they need, identifies potential complications related to medications and helps 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, 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 Baycare Health Partners for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a “pay for value” structure if it meets 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. Effective July 1, Cigna will have 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 19,000 participating primary care physicians.
Baycare Health Partners Inc. is a physician/hospital organization that includes three Baystate Health hospitals and about 1,250 physicians in about 200 medical practices in Hampden, Hampshire and Franklin counties. Baycare’s primary purpose is to foster physician/hospital cooperation in anticipating and responding to the evolving challenges of today’s practice environment, including providing managed care contracting services for members. Its mission is to improve the quality, safety, efficiency and sustainability of health care in the community.
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 .