Cigna and Houston-area Doctors Join in Collaborative Accountable Care Effort
- Consumers can benefit from improved care coordination and greater emphasis on preventive care
- Health care professionals are rewarded for improving patient health and lowering medical costs
- Program includes registered nurse clinical care coordinators
BLOOMFIELD, Conn., & HOUSTON, July 18, 2012 - Cigna (NYSE:CI) and doctors affiliated with two different Houston-area organizations -- St. Luke's Health System Clinically Integrated Providers and Renaissance Physician Organization -- have launched collaborative accountable care initiatives to 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. The programs will benefit approximately 44,000 individuals covered by a Cigna health plan who receive care from among approximately 500 health care professionals affiliated with St. Luke's Health System Clinically Integrated Providers or 1,642 health care professionals who are a part of Renaissance Physician Organization.
These newest efforts in Houston build on Cigna's push to change the health care delivery system from one that focuses on paying for volume to a system that rewards value and quality of outcomes. Including its long-standing relationship with Kelsey-Seybold in Houston and the jointly-offered product, KelseyCare Powered by Cigna, Cigna is now engaged in 32 collaborative accountable care initiatives in 16 states, encompassing more than 300,000 Cigna customers and more than 4,500 primary care physicians. Cigna launched its first collaborative care program in 2008 and has a goal to have 100 collaborative accountable care programs with one million customers in place by the end of 2014.
"Our collaboration with Cigna will help us to provide our patients with more coordinated care, aided by more complete data that gives a clearer picture of all the care a patient is receiving," said James O. Wallace, Contracts Committee Chair, St. Luke's Health System Clinically Integrated Providers. "Having this data from Cigna will help our doctors identify even more opportunities to improve patient health."
"Coordinated care is already a focus for Renaissance Physician Organization and we are pleased to extend our existing relationship with Cigna's Medicare company, HealthSpring, to also include more Cigna commercial customers," said John E. Bertini, MD FACS, chairman of Renaissance Physician Organization. We believe this model helps both doctors and patients to achieve their common goals - better health."
Through the collaborative accountable care initiatives, doctors monitor and coordinate all aspects of an individual's medical care. Patients continue to go to their current physician and automatically 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. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a doctor at one of these practices will also have access to the benefits of the program.
"A system that's focused on value rather than volume ultimately leads to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors," said Mike Koehler, president and general manager for Cigna in Houston. "These goals can only be reached by working in collaboration with physicians and hospitals, and we are pleased to launch these new collaborative accountable care programs in Houston."
Critical to the program's benefits are registered nurses, employed by the physician practices, 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 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 helps patients get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.
The care coordinators can 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.
Cigna will compensate physicians from the two organizations for the medical and care coordination services they provide. Additionally, the practices may be rewarded through a "pay for performance" structure if they meet targets for improving quality and lowering medical costs.
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 St. Luke's Health System Clinically Integrated Providers
St. Luke's Health System Clinically Integrated Providers is a clinically integrated model for its 500 physicians on staff at the St. Luke's Health System Hospitals. Clinical integration involves the sharing of information and integration of group goals to improve and standardize performance, reduce redundancy and improve patient care outcomes. For more information visit www.stlukestexas.com/IPA
About Renaissance Physician Organization
Renaissance Physician Organization (RPO) is a citywide provider-owned and operated Independent Physician Association (IPA) made up of over 1,600 Primary Care Physicians and Specialists who serve the needs of over 35,000 patients in Houston and Southeast Texas. For over a decade, RPO has been dedicated to providing coordinated, preventive care that maximizes cost efficiencies while delivering the best possible patient outcomes for their Commercial and Medicare patients. For more information, visit www.myrpo.com
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