- Patient-centered medical home model aims to improve quality of care and lower medical costs
- Primary care physicians coordinate care with added assistance from CIGNA
- Holston Medical Group serves approximately 10,000 CIGNA customers and is the largest multi-specialty physician practice in the Tri-Cities area
BLOOMFIELD, Conn. & KINGSPORT, Tenn.--(BUSINESS WIRE)-- CIGNA (NYSE:CI) and Holston Medical Group (HMG) have launched a pilot of the patient-centered medical home model, in which a primary care physician is responsible for monitoring and coordinating nearly all aspects of a patient’s medical care. This is CIGNA's only such pilot in the Tri-Cities and southwestern Virginia area.
This pilot represents a collaborative approach between CIGNA and the 150 health care professionals of Holston Medical Group to improve patient access to care, to improve continuity, coordination and quality of care, and to lower medical costs. It encompasses:
- use of electronic medical records to track medical history
- case management/disease management within the practice
- onsite urgent care
- extended hours
- education to help people navigate their health care system
- better availability of appointments
- pay for performance – doctors will be rewarded for improving quality and lowering costs
The pilot program, which began August 1, focuses on individuals, especially those with chronic illness or ongoing medical needs, who receive care from Holston Medical Group’s primary care physicians who practice family medicine, internal medicine and pediatrics.
Holston Medical Group passed a significant review process by CIGNA before qualifying for the patient-centered medical home pilot program.
Currently, more than 10,000 individuals who are covered by a CIGNA health plan receive ongoing medical services from Holston Medical Group. Of these, approximately forty percent are employed by Eastman Chemical Company or are beneficiaries covered by Eastman Chemical Company’s CIGNA health care benefit plan.
“We are honored to be designated a medical home for our patients who are employees and families of Eastman Chemical Company and CIGNA health plan-covered individuals,” Dr. Scott Fowler, president of Holston Medical Group, said. “We are excited to participate in this opportunity with CIGNA and to formalize a concept our physicians have been pursuing for some time.”
Eastman’s Director of Integrated Health David Sensibaugh said, "The current U.S. health care system is not sustainable. Self-insured employers like Eastman are very interested in innovative models of health care delivery that reward clinicians who provide high-quality and cost-effective care. It is critical that all health plans and health care professionals work collaboratively to drive systemic quality improvements that will in turn result in a more sustainable model of health care delivery.
"We commend CIGNA for being proactive in advancing new approaches to improve quality of health outcomes in our region. We also appreciate the leadership and foresight of Holston Medical Group to partner with CIGNA in a new model of health care delivery. This model will result in better health outcomes for the individual in addition to controlling costs for both the individual and company."
Primary care physicians affiliated with Holston will be paid as usual for the medical services they provide and will also be rewarded through a “pay for performance” structure if they meet targets for improving quality and enhancing access to appropriate health care. According to Dr. Robert McLaughlin, CIGNA's senior medical director for Tennessee, emphasizing the value of the primary care physician as the overall coordinator of their patients’ health will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.
To obtain the benefits of the medical home pilot, people simply access care from one of the numerous Holston Medical Group primary care physicians participating in the program. There is no change in choice of primary care doctor or in any plan requirements regarding referrals to see specialists.
“We think a patient-centered accountable care model that pays doctors for improving outcomes, lowering medical costs and providing greater value to their patients is a better model of health care than the current system that rewards doctors for performing more procedures,” Dr. McLaughlin said. “By shifting the focus from specialization to coordinated primary care, patient-centered medical homes can help improve outcomes and patient satisfaction.”
CIGNA will evaluate results after the program has been operational for at least 12 months. The pilot is one of many that CIGNA participates in nationally and is intended to help the company gather data about the effectiveness of the patient-centered models of care. CIGNA's programs include multi-payer pilots in Colorado, New Hampshire, Pennsylvania, and Vermont, as well as CIGNA-only accountable care pilots in Connecticut, Georgia, Missouri, New Hampshire and Texas. CIGNA has been a member of the Patient-Centered Primary Care Collaborative since October 2007.
CIGNA (NYSE:CI) is a global health service and financial company dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation's operating subsidiaries in the United States provide an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance. CIGNA offers products and services in over 27 countries and jurisdictions and has approximately 60 million customer relationships throughout the world. To learn more about CIGNA, visit www.cigna.com. To sign up for email alerts or an RSS feed of company news, log on to http://newsroom.cigna.com/rss. Also, follow us on Twitter at @cigna, visit CIGNA’s YouTube channel at http://www.youtube.com/cignatv and listen to CIGNA's podcast series with healthy tips and information at http://www.cigna.com/podcasts or by searching "CIGNA" in iTunes.
About Holston Medical Group
As one of the largest multi-specialty providers within the Southeast, Holston Medical Group’s “Family of Care” consists of more than 800 employees, including 150 physicians and mid-level providers in its provision of 24-hour medical/surgical coverage. Regarded as a national leader in clinical research as well as electronic health record integration and utilization, Holston Medical Group provides convenient locations throughout Northeast Tennessee and Southwest Virginia, offering two Urgent Care Clinics (Bristol & Kingsport) and state-of-the-art diagnostic capabilities. On-site ancillary services available include digital x-ray and mammography, CT, MRI, ultrasound and cardiac services. Additionally, HMG provides the patient convenience of on-site laboratory services.
KEYWORDS: United States North America Connecticut Tennessee
INDUSTRY KEYWORDS: Health Professional Services Insurance Managed Care