- Program includes a dedicated registered nurse care coordinator
- Care coordinator will emphasize wellness, disease management and health improvement
- Primary care doctors rewarded for improving patient health and lowering medical costs
BLOOMFIELD, Conn. & ST. LOUIS--(BUSINESS WIRE)-- CIGNA (NYSE:CI) and St. John’s Mercy Medical Group (SJMMG), a physician governed practice affiliated with St. John’s Mercy Health Care, have launched a patient-centered collaborative accountable care pilot program. The pilot is expected to improve access to and quality of patient care, and provide better care coordination while lowering medical costs.
A collaborative accountable care program is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs. CIGNA's program with SJMMG is one of the first patient-centered pilot programs in the St. Louis area involving a medical practice and a single private payer.
The program, which began July 1, targets individuals covered by a CIGNA health plan who receive care from one of SJMMG’s 165 primary care physicians.
“St. John’s Mercy Medical Group has always been focused on providing our patients with convenient access to great care,” said Dr. John Zalewski, president of Mercy Medical Group. “Our group was the first in Missouri to have a primary care practice certified as a patient-centered medical home by the National Center for Quality Assurance (NCQA). The collaboration with CIGNA will be yet another step we are taking to provide comprehensive and easy access for our patients.”
During the pilot, the SJMMG physician practice will monitor and coordinate all aspects of an individual’s medical care. Patients - especially those with chronic illness or ongoing medical needs - will continue to go to their current SJMMG physician and will not need to do anything additional to receive the collaborative accountable care benefits. There also is no change in any plan requirements regarding referrals to specialists.
Key to the CIGNA/SJMMG program is a registered nurse case manager who serves as the clinical care coordinator and emphasizes wellness, disease management and health improvement through direct communication with patients. The care coordinator also supports patient health management education, assists high risk patients with physician appointments, and leverages CIGNA data and the clinical programs of both SJMMG and CIGNA to enhance patient care, which is one of the core strengths of the pilot program.
“Collaborative accountable care programs can help put the health care system’s focus back where it needs to be: on the relationship between patients and their primary care physicians who provide quality care and coordinate all of that individual’s care,” said Dr. Jordan Ginsburg, CIGNA's senior medical director for Missouri. “We believe that by adopting a patient-centered model of primary care we can achieve better clinical outcomes, higher patient satisfaction and lower medical costs.”
CIGNA will pay SJMMG’s primary care physicians as usual for the medical services they provide. The physicians will also be rewarded through a “pay for performance” structure if they meet targets for improving quality and lowering medical costs. According to Ginsburg, emphasizing the value of the primary care physician will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.
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 model. CIGNA's programs include multi-payer pilots in Colorado, New Hampshire, Pennsylvania, and Vermont, as well as CIGNA-only collaborative accountable care pilots in Connecticut, Georgia, 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 St. John’s Mercy Medical Group
St. John’s Mercy Medical Group (SJMMG) is a physician-governed group practice composed of over 200 board-certified and board-eligible primary care and specialty physicians affiliated with St. John's Mercy. SJMMG has more than 80 practice sites in the St. Louis metropolitan area. For more information about SJMMG, visit www.mercymedicalgroup.com.
KEYWORDS: United States North America Connecticut Missouri
INDUSTRY KEYWORDS: Practice Management Health Hospitals Professional Services Insurance Nursing General Health Managed Care