Cigna (NYSE:CI) and Fairfax Family Practice Centers, a primary care family medical practice based in Northern Virginia, have launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the "triple aim" of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs.
Accountable care 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 collaboration with Fairfax Family Practice Centers is believed to be the first patient-centered accountable care program in Northern Virginia involving a family medical practice and a health plan.
The program will benefit approximately 9,700 individuals covered by a Cigna health plan who receive care from among 100 health care professionals at 12 practice locations. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a Fairfax Family Practice Centers physician will also have access to the benefits of the program.
"Providing continuing and comprehensive care to our patients and helping each one of them achieve their optimal health is fundamental to our medical practice," said Dr. Jim Jenkins, president of Fairfax Family Practice Centers. "We look forward to collaborating with Cigna to deliver more coordinated care that will help our patients lead healthier lives."
Fairfax Family Practice Centers will monitor and coordinate all aspects of an individual's medical care. Patients will continue to go to their current physician and will not need to do anything to receive the benefits of the program. There also 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 Fairfax Family Practice Centers, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators will enhance care by using patient-specific data from both organizations 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 are part of the physician-led care team that helps patients get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.
The care coordinators will 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.
"We need a patient-centered health care system that emphasizes prevention and primary care and rewards physicians for quality of care and improved health outcomes," said Julia Huggins, president, Cigna Mid-Atlantic. "A system that's focused on value rather than volume will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors."
Cigna will compensate Fairfax physicians for the medical and care coordination services they provide. Additionally, the practice may be rewarded through a "pay for performance" structure if it meets targets for improving quality and lowering medical costs.
"Employers bear a large portion of the nation's health care costs, so they welcome programs that aim to lower medical costs through improved health," said John Miller, executive director of the MidAtlantic Business Group on Health. "Cigna's patient-centered collaboration with Fairfax Family Practice Centers is an excellent example of how health plans and physicians can work together to achieve a healthy, productive work force and create a health care system that works for all of us."
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