Cigna and HealthTexas Provider Network Bring Accountable Care to North Texas
09 April 2012
- Consumers benefit from improved care coordination and greater emphasis on preventive care
- Primary care doctors are rewarded for improving patient health and lowering medical costs
- Program includes registered nurse clinical care coordinators
BLOOMFIELD , Conn., and DALLAS - April 9, 2012 - Cigna (NYSE:CI) and HealthTexas Provider Network (HTPN),a large physician group in the Dallas/Ft. Worth Metroplex that's affiliated with Baylor Health Care System, have launched a collaborative accountable care initiativeto 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 accomplishing the same population health goals as accountable care organizations, or ACOs.
Accountable care 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 collaboration with HTPN is believed to be the first patient-centered accountable care program in North Texas involving a hospital-affiliated group of physicians and a health plan.
The program will benefit nearly 7,000 individuals covered by a Cigna health plan who receive care from among approximately 90 HTPN primary care physicians throughout the Metroplex. Individuals who are enrolled in a Cigna health plan and later choose to seek care from an HTPN physician will also have access to the benefits of the program.
"There's nothing more important to our physicians than helping our patients stay healthy so they can live their lives to their full potential," said F. David Winter, M.D., MSc, MACP, president, chairman and chief clinical officer, HTPN. "This collaboration with Cigna is an opportunity to do the very best for our patients at every opportunity with new teamwork principles that continue even after the patient has left the clinic."
HTPN 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 take any action 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.
Critical to the program's benefits are registered nurses, employed by HTPN, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the 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.
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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 need to create a health care system that's patient-centered and emphasizes prevention and primary care while rewarding physicians for quality of care and improved health outcomes rather than volume of services," said Dr. Frederick Watson, Cigna's medical officer for North Texas. "If we place our focus on value rather than volume we can ultimately have a healthier population and lower medical costs, which is good for individuals, families, employers and health care professionals."
Cigna will compensate HTPN physicians for the medical and care coordination services they provide. Additionally, the practice may be rewarded through a "pay for performance" structure if it meets targets for improving quality and lowering medical costs.
"Employers bear a large portion of the nation's health care costs, so they welcome programs that focus on lowering medical costs through improved health," said, Marianne Fazen, executive director of the DFW Business Group on Health. "Cigna's patient-centered collaboration with HTPN is an excellent example of how health plans and physicians can work together to achieve a healthy, productive work force and create a health care system that works for all of us."
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 physician practices. Cigna is now engaged in 28 patient-centered initiatives in 17 states, including six multi-payer pilots and 22 Cigna-only collaborative accountable care initiatives. The collaborative accountable care initiatives encompass more than 270,000 Cigna customers and more than 4,000 physicians. Cigna has been a member of the Patient-Centered Primary Care Collaborative since October 2007.
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.
About HealthTexas Provider Network
HealthTexas Provider Network was established in 1994. Headquartered in Dallas, TX, HealthTexas is a multi-specialty medical group that employs over 580 physicians practicing in 183 care delivery sites in the North Texas area. This medical group practice is comprised of 66 primary care centers, 106 specialty care centers, 9 physiatric medicine centers, 7 hospitalist programs, 3 pulmonary critical care units, 12 liver disease outreach centers, 3 senior health centers, 21 cardiovascular care sites, 2 MRI centers and a family practice residency program. In FY11 HealthTexas reported more than 1.5 million patient visits per year, and $487 million in gross revenue making them one of the leading medical groups in the nation. HealthTexas was named a 2011 American Medical Group Association (AMGA) Acclaim Award Honoree, and in 2010 it received AMGA's Medical Group Preeminence Award.
About Baylor Health Care System
Baylor Health Care System is a not-for-profit, faith-based supporting organization providing services to a network of acute care hospitals and related health care entities that provide patient care, medical education, research and community service. Baylor recorded more than 2.8 million patient encounters, $4 billion in total operating revenue, $5.2 billion in total assets and $447 million in community benefit in fiscal year 2011. Baylor's network of 312 access points includes 30 owned/operated/ ventured/affiliated hospitals; 27 joint ventured ambulatory surgical centers; satellite outpatient locations; senior centers and more than 183 HealthTexas Provider Network physician clinics.
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