Cigna and Health4 Form "Pay for Quality" Agreement that Rewards Better Quality, Lower Health Care Costs
22 May 2012
- Physicians and hospitals are rewarded for improving patient health and lowering medical costs
- Patients benefit from improved care coordination and greater emphasis on preventive care
- Data sharing is central to new agreement
BLOOMFIELD , Conn., and COLUMBUS, Ohio - May 22, 2012 - Cigna (NYSE:CI) and Health4 have launched a "pay for quality " initiative that rewards central Ohio physicians and hospitals for improving health care quality and holding the line on costs. Cigna will share its clinical and claims data with Health 4 so health care professionals can better identify and address potential gaps in patient care for Cigna customers. Examples of gaps include missed preventive care screenings, skipped tests that help people manage a chronic condition, serious health care problems that, if not addressed, would lead to a hospital readmission, and prescriptions left unfilled.
Under the agreement, Cigna will compensate Health 4 physicians and hospitals for the medical care they provide. Cigna will then pay additional reimbursement under a "pay for quality" structure when physicians and hospitals meet mutually-agreed upon targets for improving quality and lowering medical costs.
Health 4 is a clinically-integrated health care delivery model comprising approximately 1,700 Medical Group of Ohio primary and specialty care physicians as well as OhioHealth's hospitals, including Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital-Columbus, Grady Memorial Hospital, Dublin Methodist Hospital, Doctors Hospital-Nelsonville, Hardin Memorial Hospital and Marion General Hospital.
"Health 4 shares Cigna's vision to reward health care professionals for providing the right care, at the right time, in the right setting, which leads to better outcomes and reduced costs for individuals and their employers," said Vincent Sobocinski, president and general manager for Cigna in Ohio. "Now doctors and hospitals will have access to better data to help them to be successful. The data gives them a much fuller picture of all of the care their patient has received or care the patient might have missed."
The program will benefit more than 17,000 individuals covered by a Cigna health plan who receive care from Health 4-affiliated doctors and hospitals. 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, including those regarding referrals to specialists.
"Health 4 is being utilized by more patients than any other clinically integrated network in central Ohio. We're pleased to partner with Cigna to work with health care professionals to change the way health care is delivered and paid for by focusing on quality and outcomes instead of how much care is provided," said Lou Imbrogno, president, OhioHealth Group/Health 4. "Health 4 is a proven, effective approach to care, cost and efficiency."
This approach is one of several pay for value models that Cigna is using to drive health care quality and cost improvements. Cigna is engaged in 28 patient-centered initiatives in 17 states, including six multi-payer pilots and 22 Cigna-only collaborative accountable care initiatives that seek to achieve the "triple aim" of improved health outcomes (quality), lower total medical costs and increased patient satisfaction.
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 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 and vision care benefits, and other related products including group disability, life, and accident coverage. Cigna has sales capability in 30 countries and jurisdictions, with approximately 70 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
OhioHealth is a nationally recognized, faith-based, not-for-profit, charitable, healthcare organization serving and supported by the community. Named by Thomson Reuters as one of the 10 best healthcare systems in America three years in a row, OhioHealth also has been recognized by FORTUNE magazine as one of the "100 Best Companies to Work For" six years in a row, 2007-2012.
Based in Columbus, Ohio, it is a family of 21,000 associates, physicians and volunteers, 18 hospitals, 21 health and surgery centers, home-health providers, medical equipment and health service suppliers throughout a 40-county area. OhioHealth member hospitals include Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital-Columbus, Grady Memorial Hospital, Dublin Methodist Hospital, Doctors Hospital-Nelsonville, Hardin Memorial Hospital and Marion General Hospital. For more information, please visit our website at ohiohealth.com.
About Medical Group of Ohio
The Medical Group of Ohio (MGO) is an organization of health care professionals working together, as a business, to improve the process of delivering health care and to enhance the professional satisfaction of its members. MGO has effectively remained at the forefront of health care changes on behalf of physicians for the past 17 years. MGO - working together with OhioHealth created a clinically integrated network via Health4 that has not only set the standard for clinically integrated care in central Ohio, but has created a sustainable approach to serve you and make the practice of medicine more fulfilling for years to come. Please visit the web site at www.theMGO.com
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