BLOOMFIELD, Conn. & MEMPHIS, Tenn., September 08, 2011 - Cigna (NYSE:CI) and Health Choice, a Physician Hospital Organization (PHO) affiliated with Methodist Le Bonheur Healthcare, 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 accountable care organizations, or ACOs.
An ACO 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 Health Choice is the first patient-centered accountable care program in the Memphis area involving a group of independent medical practices and a health plan.
The program is focused on approximately 17,000 individuals covered by a Cigna health plan who receive care from among 29 doctors at seven participating physician practices. Individuals who are enrolled in a Cigna health plan and later choose to seek care from one of the participating practices will also have access to the benefits of the program.
"Nothing is more important to our physicians than helping patients improve their health," said George Mayzell, M.D., chief executive officer of Health Choice. "We look forward to collaborating with Cigna to deliver more coordinated care that will help our patients lead healthier lives."
The participating physician practices 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.
Key to the program are registered nurses, employed by Cigna and Health Choice, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate their health care system. The care coordinators will 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 will 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.
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 believe that the current health care system, which is focused on providing 'sick care' and rewards physicians for volume, isn't sustainable," said Dr. Robert McLaughlin, Cigna's senior medical director for Tennessee. "We need to shift to a patient-centered system that emphasizes prevention and primary care and that rewards physicians for quality of care and improved health outcomes. That will ultimately result in a healthier population and lower medical costs."
Cigna will pay physicians as usual for the medical services they provide. The physicians also will be rewarded through a "pay for performance" structure if they meet targets for improving quality and lowering medical costs. According to Cigna's McLaughlin, emphasizing the value of the primary care physician will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.
"Programs that aim to improve health and lower medical costs are very much welcomed by employers, who bear so much of the nation's health care costs," said Cristie Upshaw Travis, chief executive officer of the Memphis Business Group on Health (MBGH). "This patient-centered collaboration between Cigna and Health Choice will help us learn how to achieve a healthy, productive work force and a health care system that works for everyone. MBGH looks forward to watching the progress this initiative makes."
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 the physician practice. With the addition of Health Choice, Cigna is now engaged in 15 patient-centered initiatives in 13 states, encompassing more than 115,000 Cigna customers and more than 1,800 physicians, including multi-payer pilots and Cigna-only collaborative accountable care initiatives. The company plans to increase the number of initiatives significantly in 2011 and 2012. 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 maintains sales capability in 30 countries and jurisdictions and has approximately 66 million customer relationships throughout the world. All products and services are provided exclusively by such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Life Insurance Company of North America, Cigna Life Insurance Company of New York, and Connecticut General Life Insurance Company. 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://www.cigna.com/newsroom/rss. Also, follow us on Twitter at @cigna, visit Cigna's YouTube channel at http://www.youtube.com/cigna 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 Health Choice, LLC
Health Choice is a joint venture of Metrocare Physicians, Inc. (Metrocare) and Methodist Le Bonheur Healthcare (MLH). Formed in 1985 and reorganized as a true joint venture in 1997, Health Choice has a legacy of promoting partnership and success between and for physician practices and MLH. Health Choice operates exclusively in the Mid-South and contracts for and services over 1,400 area physician practices as well as MLH. Health Choice has built the largest market share of any managed care organization in the Mid-South. In this era of unprecedented change, Health Choice is committed to assisting physicians in adapting and thriving. Health Choice helps Metrocare and MLH navigate the healthcare future and delivers powerful solutions to help ensure their future success. www.myhealthchoice.com