PHOENIX, December 07, 2012 - Cigna Medical Group (CMG) today announced the Pacific Business Group on Health (PBGH) has chosen CMG to participate in Wave I of its Intensive Outpatient Care Program (IOCP) for Medicare beneficiaries. The three-year program, which is supported by a $19 million grant through the Centers for Medicare & Medicaid Services' (CMS) Center for Medicare and Medicaid Innovation (CMMI), uses intensive coordinated care to achieve improved health outcomes among high-risk patient populations and significantly reduce their cost of care.
CMG is an ideal candidate for the IOCP effort and was chosen in part because of the many CMG programs that have earned positive results for commercial and individual customers and which share the IOCP goals of improved patient outcomes, better patient satisfaction and lower health care costs (triple aim). Recently, CMG was part of a study in the leading policy journal Health Affairs, which cited Cigna's early successes with Accountable Care Organizations (ACO). CMG is the medical group practice division of Cigna HealthCare of Arizona, Inc., which holds the distinction of being the highest rated Medicare Advantage plan in Arizona, with a 4.5 star rating from CMS.
"CMG has long focused on outcomes-based care and delivering the highest quality health care to our Medicare patients in Arizona through personalized, coordinated and preventive care," said Edward Kim, president and general manager of CMG. "The grant enhances our ability to achieve our patient care goals while improving the affordability of care for high-risk individuals and we are looking forward to the partnership with PBGH on this effort."
Developed by Pacific Business Group on Health Medical Director, Dr. Arnie Milstein and a team of caregivers, the Intensive Outpatient Care Program has been piloted by PBGH member organizations. The model has shown it can reduce health care costs for chronically ill patients by as much as 20 percent and has been written about extensively.
The IOCP uses well trained care managers embedded in high-performing primary care teams to develop close relationships with medically complex patients. The IOCP will deliver highly individualized and accessible primary care, based on treatment goals that are specific to each patient. The goal is to engage the patients in intensive care management to improve patient self-management, patient experience and clinical outcomes. This should result in better mitigation of disease, reduced complications, reduced avoidable hospitalizations and emergency room visits.
"Coordinated care is a proven delivery model, and the IOCP grant affords an opportunity to realize its full potential for patients needing it most," said Dr. Arnie Milstein, Professor of Medicine at Stanford University and Medical Director of PBGH. "PBGH is pleased to partner with CMG to make a positive impact on the health of patients in Arizona."
The Innovation Grant will enable PBGH and CMG to implement and enhance intensive care management for high-risk Medicare beneficiaries. The goal is to reduce the total cost of care for these beneficiaries while improving their health outcomes and patient-reported experience annually.
In participating in the IOCP, CMG will employ its new CustomCare program to help patients obtain intensive outpatient care for their chronic conditions, such as heart disease, diabetes and chronic obstructive pulmonary disease, at the doctor's office or at home when necessary. CustomCare is also designed to assure that patients get the care they need quickly after a hospital admission. The commonalities and shared goals of the IOCP and CustomCare program will ensure seamlessness for customers and complementary efficiency and effectiveness.
PBGH plans to select 20 organizations as part of the IOCP program and CMG is one of the 10 organizations selected for the first round of implementation, planned to go live in June 2013. CMG estimates 10 percent of its Medicare customers will be involved in the IOCP effort.
"CMG's involvement in this important program underscores Cigna's dedicated focus to quality care and the triple aim and recognizes our continued commitment to our customers to deliver the best possible health care," said Matt Manders, president of regional and operations for Cigna.
Founded in 1989, Pacific Business Group on Health (PBGH) is one of the nation's leading non-profit business coalitions focused on health care. We help leverage the power of our 50 large purchaser members who spend 12 billion dollars annually to provide health care coverage to more than 3 million employees, retirees and dependents in California alone. PBGH works on many fronts to improve the quality and affordability of health care, often in close partnership with health insurance plans, physician groups, consumer organizations, and others concerned about our health care system.
About the Center for Medicare and Medicaid Innovation Grants
Made possible by the health care law - the Affordable Care Act - the awards will support projects nationwide that are designed to deliver high quality medical care, improve patient experience, enhance the health care workforce and reduce health care costs. Combined with the initial awards already announced, HHS has now made awards to 107 projects that have the potential to save the health care system an estimated $1.9 billion over the next three years. Awardees were chosen for their innovative solutions to the health care challenges facing their communities and for their focus on creating a well-trained health care workforce that is equipped to meet the need for new jobs in the 21st century health system. The Centers for Medicare & Medicaid Services (CMS) contracted with an external organization with extensive experience in managing independent grant review processes to administer the award review process to ensure an objective review of each application. The Center for Medicare and Medicaid Innovation within CMS will administer the awards through cooperative agreements over three years.
Cigna Corporation (NYSE: 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 71 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
About Cigna Medical Group
Cigna Medical Group (CMG), the group practice division of Cigna HealthCare of Arizona, Inc. is an NCQA-recognized Patient-Centered Medical Home and one of the Valley's largest multi-specialty group practices with 23 health care centers and two convenience care clinics located throughout metropolitan Phoenix. Each health care center is equipped with several medical services under one roof, so additional diagnostic needs such as lab work, imaging-even prescriptions-can be quickly obtained. CMG is also the group medical practice for Cigna HealthCare of Arizona's Medicare Advantage Plan*, the highest-rated plan in Arizona, with 4.5 out of 5 stars for 2013 by www.medicare.gov. *Plan performance summary star ratings are assessed each year and may change from one year to the next.
The project described was supported by Funding Opportunity Number CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.