KIRKLAND, Wash., July 09, 2014 - Cigna (NYSE: CI) and EvergreenHealth Partners (EHP) have launched a collaborative care initiative to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. The program became effective July 1 and is Cigna's third collaborative care arrangement in Washington state. There are now 100 of these arrangements nationwide.
EvergreenHealth Partners is a clinically integrated network of more than 500 physicians and health care professionals affiliated with EvergreenHealth, a 318-bed acute care hospital and health system located in Kirkland, Washington.
Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit nearly 5,700 individuals covered by a Cigna health plan who receive care from EHP primary care doctors and specialists.
In places where it's been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while holding the line on medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reducing unnecessary use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.
"We are acutely focused on advancing the health of the community we serve through our dedication to high-quality, safe, compassionate and cost-effective health care. By working collaboratively with Cigna and focusing on improved care coordination and preventive care, we hope to drive even higher quality of care, better health and an enhanced patient experience," said Bob Malte, CEO of EvergreenHealth.
"This collaboration presents an excellent opportunity to help create a better health care delivery system," said John Sobeck, M.D., Cigna's senior medical director for Washington. "When we reward doctors for results and focus on prevention, wellness, health improvement and care coordination, we can create a system that works for everyone who uses, pays for or delivers health care."
Under the program, EHP will monitor and coordinate all aspects of an individual's medical care. Patients will continue to go to their current EHP health care professional and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from an EHP health care professional 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, heart disease and obesity.
Critical to the program's benefits are the registered nurse clinical care coordinators, employed by EvergreenHealth and its partners, who will 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 medical group and Cigna, which will ultimately provide 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 will help patients get the follow-up care or screenings they need, identify potential complications related to medications and help 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, such as disease management programs for diabetes, heart disease and other chronic conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.
Cigna will compensate EvergreenHealth Partners for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a "pay for value" structure if it meets targets for improving quality and lowering medical costs.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 100 Cigna Collaborative Care arrangements with large physician groups that span 27 states, reach more than one million commercial customers and encompass more than 39,000 doctors, including more than 19,000 primary care physicians and more than 20,000 specialists.
Cigna Collaborative Care is one component of the company's approach to physician engagement for health improvement, which also includes the innovative Cigna-HealthSpring® care model for Medicare customers. Today, more than 1.3 million Cigna and Cigna-HealthSpring customers benefit from 265 engaged physician relationships across 31 states, with more than 66,000 doctors participating, including more than 25,000 primary care physicians and more than 41,000 specialists.
EvergreenHealth is an integrated health care system that serves nearly 850,000 residents in King and Snohomish counties. Formed as a public hospital district in 1972, EvergreenHealth is now a 318-bed acute care hospital and health system located in Kirkland and includes 24-hour Level III trauma emergency and critical care. EvergreenHealth also provides primary, urgent, specialty and 24/7 emergency care at its EvergreenHealth Medical Center in Redmond and operates nine primary care clinics, an additional urgent care center in Woodinville and a senior clinic. More than 950 physicians on EvergreenHealth's medical staff provide clinical excellence within more than 70 specialties, including cardiac, surgical, orthopedic, cancer, neurological, neonatal, hospice, pulmonary, sleep, and home-health care. In addition to clinical care, EvergreenHealth offers extensive community health outreach and education programs, anchored by the 24/7 EvergreenHealth Nurse Navigator & Healthline. EvergreenHealth is partners with Virginia Mason Medical Center and the Seattle Cancer Care Alliance. For more information, visit www.evergreehealth.com.
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 more than 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.