Cigna has expanded its collaborative accountable care program through 10 new initiatives with physician groups in seven states - Colorado, Maine, New York, North Carolina, Tennessee, Texas and Virginia. With the addition of these initiatives, Cigna now has 22 collaborative accountable care programs in 13 states covering more than 270,000 customers and is positioned to reach its goal of 100 initiatives for 1 million customers by 2014. Cigna launched its first collaborative accountable care program in 2008.
“Our existing programs are making excellent progress, so we're more convinced than ever that Cigna's collaborative approach to accountable care is the right model for how health care should be practiced in the U.S.”
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:
Kennebec Region Health Alliance, a large physician hospital organization (PHO) in Augusta and Waterville, Maine, that's affiliated with MaineGeneral Medical Center. www.mainegeneral.org
Penobscot Community Health Care, Maine's largest and most comprehensive community health center, with 15 practice sites in the greater Bangor region. www.pchc.com
The Jackson Clinic, the first multi-specialty group practice in Tennessee, with eight locations in Jackson and offices in four other West Tennessee communities. www.jacksonclinic.com
WESTMED Medical Group, the largest private group medical practice in central and lower Westchester County, N.Y. www.westmedgroup.com
Fairfax Family Practice Centers, a primary care family medical practice based in Northern Virginia. www.FairfaxFamilyPractice.com
Bon Secours Medical Group, the physician practice group of Bon Secours Virginia Health System in Richmond, Va. http://www.bonsecours.com/find-a-physician-bon-secours-medical-group.html
Key Physicians, an independent physician organization serving Raleigh/Durham, N.C. www.keymedicalhome.com
Cornerstone Health Care, a large multi-specialty physician group in High Point, Winston-Salem and Greensboro, N.C., and surrounding areas. www.cornerstonehealth.com
HeathTexas Provider Network (HTPN), a large physician group in the Dallas/Ft. Worth Metroplex that's affiliated with Baylor Health Care System. www.healthtexas.com
Colorado Springs Health Partners (CSHP), a large multi-specialty physician group in Colorado Springs. www.cshp.net
Collaborative accountable care is already helping to improve the health of Cigna customers where the program has been introduced. For example, Celia is a Cigna customer in North Texas who had difficulty managing her diabetes and often had to go to the emergency room or be hospitalized. Her care coordinator at Medical Clinic of North Texas worked with a Cigna case manager to set up a home visit program for Celia and also scheduled weekly visits for lab work to monitor Celia's condition. As a result of this enhanced care, Celia's blood sugar levels stabilized and she avoided emergency room visits and hospitalization.
"Our existing programs are making excellent progress, so we're more convinced than ever that Cigna's collaborative approach to accountable care is the right model for how health care should be practiced in the U.S.," said Alan Muney, M.D., Cigna's chief medical officer. "Cigna sets the bar high for physician groups to participate in our collaborative accountable care initiatives and these 10 groups are excellent additions to the program. Each group is 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."
"Most employers will tell you 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. "Employers and individuals continue to spend more and more for health care that isn't as coordinated as well as it should be, and doctors are rewarded for volume rather than for improved health outcomes. Cigna's collaborative accountable care holds great promise to deliver better quality at lower costs. I congratulate Cigna and these 10 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 28 patient-centered initiatives in 17 states, including six multi-payer pilots and 22 Cigna-only collaborative accountable care initiatives. The collaborative accountable care initiatives encompass more than 270,000 Cigna customers and more than 4,000 physicians. Cigna has been a member of the Patient-Centered Primary Care Collaborative since October 2007.
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