- 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 registered nurse clinical care coordinators
- Cigna on path to reach 2014 goal of 100 accountable care initiatives for 1 million customers
BLOOMFIELD, Conn.--(collaborative accountable care program through new initiatives with physician groups in six states – California, Colorado, Maine, Ohio, Texas and Vermont. With the addition of these initiatives, plus a recently announced initiative with Granite Healthcare Network in New Hampshire, Cigna now has 32 collaborative accountable care programs in 16 states covering more than 300,000 customers, and is positioned to reach its goal of 100 initiatives for 1 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.
The newest members of Cigna's network of collaborative accountable care initiatives are:
In California: Palo Alto Medical Foundation, a large multispecialty medical practice in the Bay Area that's affiliated with the Sutter Health family of not-for-profit hospitals. http://www.pamf.org/
In Colorado: New West Physicians Group, a primary care group medical practice with 16 office locations throughout the Denver metro area. http://www.nwphysicians.com/
In Maine: Martin's Point Health Care, a primary care medical practice in Bangor, Portland and other Maine communities, plus Portsmouth, N.H. http://www.martinspoint.org/
In Maine: Mercy Health System, a comprehensive health care delivery organization with locations throughout greater Portland. http://www.mercyhospitalstories.org
In Ohio: Mount Carmel Health Partners, a comprehensive integrated delivery system in Columbus. http://www.mountcarmelhealth.com
In Texas: Renaissance Physician Organization, an independent physician association that provides primary and specialty medical care in Houston and southeast Texas. http://www.myrpo.com/
In Texas: St. Luke's Health System Clinically Integrated Providers, a multispecialty independent practice association affiliated with St. Luke's Episcopal Health System in the Houston area. https://www.stlukestexas.com/IPA
In Vermont: Fletcher Allen Health Care, an integrated delivery system in Burlington that's affiliated with the University of Vermont College of Medicine. http://www.fletcherallen.org/ and http://www.cvmc.org
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, 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.
"Our collaborative accountable care programs continue to make excellent progress to the benefit of our clients and customers, and our goal to have 100 programs reaching one million individuals by the end of 2014 is on track," said Alan M. Muney, M.D., Cigna's chief medical officer. "We set the bar high for participation in these initiatives. These physician groups are committed to putting the patient at the center of its practice, with expanded access to care, better coordination of care, patient education about chronic conditions and wellness, access to clinical programs for health improvement, and smart use of technology that improves the patient experience."
"There is widespread agreement among employers that our nation's health care delivery system is broken and needs to be repaired," said Helen Darling, president and chief executive officer of the National Business Group on Health. "Rather than compensating doctors for the volume of care they provide, we need to create a system that's focused on payment for value. Cigna's collaborative accountable care initiatives hold great promise to deliver better quality at lower costs. I congratulate Cigna and these physician groups for their 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 programs' benefits are registered nurses, employed by the physician practices, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. 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. The 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 physicians 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. Cigna is now engaged in 38 patient-centered initiatives in 19 states, including six multi-payer pilots and 32 Cigna-only collaborative accountable care initiatives. The collaborative accountable care initiatives encompass more than 300,000 Cigna customers and more than 4,500 primary care physicians.
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 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 and vision care benefits, and other related products including group disability, life, and accident coverage. Cigna has sales capability in 30 countries and jurisdictions, with approximately 70 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