PURCHASE, N.Y., October 21, 2015 - Third-year results from Cigna's (NYSE: CI) collaborative care initiative with WESTMED Medical Group indicate that the program continues to make excellent progress toward achieving improved health, affordability and patient experience.
Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The initiative has helped WESTMED deliver a higher level of care to nearly 6,500 Cigna customers in the Westchester County, with a strong emphasis on improved quality, lower use of the emergency room for non-emergencies and reduced hospital admissions.
For the year ending March 31, 2015, WESTMED's quality index (a measure of how well doctors comply with evidence-based medical guidelines) was 6 percent better than market, which means WESTMED performed significantly better than other medical practices in the New York metro area. In addition, WESTMED's quality is trending better than the market, which means that WESTMED continues to improve quality at a faster rate than other medical groups; and WESTMED achieved this in a market with the second highest compliance rate in the country.
While improving quality, WESTMED also lowered total medical costs by 2.8 percent while the rest of the market increased by 6.7 percent.
Several factors drove the group's strong quality index and quality trend results:
- Overall measure for diabetes care is 16 percent better than market
- Adolescent well-care rate is 14 percent better than market
- Breast cancer screening is 9 percent better than market
- Cervical cancer screening is 5 percent better than market
- Nine of its top 10 quality measures are at or better than market, with the tenth at 99 percent of market
Overuse of emergency room (ER) services, especially for non-emergencies, contributes significantly to increased medical costs. WESTMED has taken a number of steps to reduce ER use, such as extending office hours and opening urgent care centers.
A key objective of Cigna Collaborative Care is to help individuals get the right care in the right setting, which helps improve care while making it more affordable. Certain conditions, such as diabetes, high blood pressure, pulmonary disease and bacterial pneumonia, require timely outpatient care to prevent ER visits, hospitalization, complications or more severe disease.
For these time-sensitive conditions, in the year ending March 31, 2015, WESTMED:
- Reduced ER visits by 23 percent from previous year
- Reduced hospital admissions by 64 percent from previous year
- Reduced cost per hospital admission by 48 percent from previous year
During this period WESTMED also:
- Reduced inpatient costs by 6 percent while the market increased 5.5 percent
- Reduced outpatient costs by 4.2% the while market increased 3.2 percent
- Reduced ER cost per visit 2.2 percent better than market
"Our goal is to continuously improve quality while making healthcare more affordable and accessible, and these excellent results show that we're succeeding," said Dr. Simeon A. Schwartz, president and CEO of WESTMED Medical Group. "Our close collaboration with Cigna and the hard work and dedication of our clinical team, including our care coordinators, all played a vital role in driving this success."
"We congratulate WESTMED for its commitment to Cigna Collaborative Care and for its strong focus on quality improvement," said E. David Perez, M.D., senior medical director for Cigna in New York and New Jersey. "These results show that better health, a better experience and affordable care are all possible when a health plan and health care professionals work together to achieve common goals."
Critical to the program's benefits are WESTMED nurses 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 WESTMED physicians and Cigna that ultimately results in a better experience for the individual.
The care coordinators enhance care by using patient-specific data from Cigna to help identify individuals being discharged from the hospital who might be at risk for readmission, as well as people 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.
The care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support programs that may be available to them through their employer's benefit plan.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 134 Cigna Collaborative Care arrangements with large physician groups. They span 29 states, reach nearly 1.5 million commercial customers and encompass nearly 60,000 doctors, including approximately 30,000 primary care physicians and 30,000 specialists.
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 89 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 WESTMED Medical Group
WESTMED Medical Group is a large multi-specialty group medical practice, with headquarters in Purchase, NY. It is staffed by a team of 318 physicians dedicated to providing coordinated, efficient and the highest quality of patient care at its nine locations in central and lower Westchester County and Fairfield County, including a newly opened large medical office in Greenwich. The practice, known for its one-stop-shopping medical experience for patients, uses state-of-the-art systems and electronic medical records. WESTMED has New York medical offices in White Plains, Rye, Yonkers, Purchase, Scarsdale, and New Rochelle, with Connecticut offices in Greenwich and Darien.