Cigna and Tucson-area Doctors Join in Collaborative Accountable Care Effort
- Consumers can benefit from improved care coordination and greater emphasis on preventive care
- Health care professionals are rewarded for improving patient health and lowering medical costs
- Program includes registered nurse clinical care coordinators
BLOOMFIELD, Conn. & TUCSON, Ariz.--(BUSINESS WIRE)-- Cigna (NYS: CI) and doctors affiliated with two different Tucson-area organizations -- Arizona Community Physicians and Arizona Connected Care -- have launched collaborative accountable care initiatives to improve patient access to health care, enhance care coordination, and achieve the "triple aim" of improved health, affordability and patient experience. The programs, Cigna's first collaborative accountable care initiatives in Tucson, became effective July 1.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The programs will benefit approximately 12,000 individuals covered by a Cigna health plan who receive care from among approximately 119 health care professionals affiliated with Arizona Community Physicians or 217 health care professionals who are a part of Arizona Connected Care.
"We share a commitment with these physician practices to prevention, improving health care quality and changing the health care system from one that focuses on volume to one that focuses on value and quality of care," said John Keats, M.D., Cigna's senior medical director for Arizona. "Extending our initiatives into Tucson means that more people in Arizona will have access to the benefits of the program, which has shown strong early results in Phoenix."
Under the program, doctors monitor and coordinate all aspects of an individual's medical care. Patients continue to go to their current physician and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a doctor in one of the medical groups will also have access to the benefits of the program. There 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 the medical groups, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the physician practices and Cigna that ultimately results in a better experience for the individual.
The care coordinators will enhance care by using patient-specific data from Cigna to help 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, identifies potential complications related to medications and helps prevent chronic conditions from worsening.
Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support programs that may be available as part of their employee benefits plan. Examples include disease management programs for diabetes, heart disease and other conditions, and lifestyle management programs for tobacco cessation, weight management and stress management.
Cigna will compensate the two physician organizations for the medical and care coordination services they provide. Additionally, they will be rewarded through a "pay for value" structure for meeting 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 has 66 collaborative accountable care initiatives in 26 states, encompassing more than 700,000 commercial customers and more than 27,000 doctors, including more than 12,500 primary care physicians and nearly 14,500 specialists. Cigna launched its first collaborative accountable care program in 2008 and its goal is to have 100 of them in place with one million customers in 2014.
Collaborative accountable care is one component of the company's approach to physician engagement for health improvement, which also includes Cigna-HealthSpring's care model for Medicare customers. Taken together, these 231 programs in 31 states reach more than one million customers and have nearly 55,000 participating doctors, including nearly 19,000 primary care physicians and nearly 36,000 specialists.
Cigna Corporation (NYS: 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 by or 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, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has approximately 80 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
Amy Turkington, 440-934-5385
KEYWORDS: United States North America Arizona Connecticut
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