CaroMont Medical Group and Cigna Start Accountable Care Program to Improve Health and Lower Costs
- 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 care coordinators aligned with Cigna case managers
GASTONIA, N.C. & BLOOMFIELD, Conn., July 01, 2013 - Cigna (NYSE: CI) and CaroMont Medical Group, a multi-specialty network of 44 physician practices within five counties and two states, have launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination, and achieve the "triple aim" of improved health, affordability and patient experience. The program becomes effective today.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 3,000 individuals covered by a Cigna health plan who receive care from CaroMont physicians.
"This is a win-win-win for all of us - CaroMont Health, Cigna and our patients," said Dr. Randall Gehle, D.O., CaroMont Family Medicine. "CaroMont and Cigna can synergistically empower our 17 Level 3 National Committee for Quality Assurance (NCQA) recognized primary care practices to further enhance comprehensive well care and primary prevention to our patients. Patients benefit from more streamlined services using shared technology to better care for patients in a timely fashion and save everyone precious health care dollars; this is the future of medicine."
"Cigna welcomes CaroMont Medical Group as we continue to expand our successful collaborative accountable care program across the Carolinas," said Edward Hunsinger, M.D., Cigna's senior medical director for the Carolinas. "This collaboration aims to fundamentally change the health care delivery system by rewarding physicians for results. Our mutual goal is a system of enhanced patient-centered care that is focused on prevention and wellness, resulting in a healthier population and lower medical costs."
Under the program, CaroMont Medical Group monitors and coordinates all aspects of an individual's medical care. Patients continue to go to their current physician and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a doctor in the medical group 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 or heart disease.
Critical to the program's benefits are registered nurses, employed by CaroMont Medical Group, 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 the medical group and Cigna that ultimately results in 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 helps patients get the follow-up care or screenings they need, identifies potential complications related to medications and helps 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 conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.
Cigna will compensate CaroMont Medical Group 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.
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 has 66 collaborative accountable care initiatives in 26 states, encompassing more than 700,000 commercial customers and more than 27,000 doctors, including more than 12,500 primary care physicians and nearly 14,500 specialists. Cigna launched its first collaborative accountable care program in 2008 and its goal is to have 100 of them in place with one million customers in 2014.
Collaborative accountable care is one component of the company's approach to physician engagement for health improvement, which also includes Cigna-HealthSpring's care model for Medicare customers. Taken together, these 231 programs in 31 states reach more than one million customers and have nearly 55,000 participating doctors, including nearly 19,000 primary care physicians and nearly 36,000 specialists.
About CaroMont Health
CaroMont Health is a not-for-profit health system that provides inpatient and outpatient medical services within five counties and two states. CaroMont Health employs nearly 3,900 healthcare professionals with a medical staff membership of 455. CaroMont Health is comprised of five entities: CaroMont Regional Medical Center, CaroMont Medical Group, Gaston Hospice, Courtland Terrace and CaroMont Specialty Surgery. CaroMont Health has been recognized for its quality and overall performance by Truven Health Analytics, 100 Top Hospitals; HealthGrades, Clinical Excellence Distinction for four years in a row - 2010, 2011, 2012 and 2013; Leapfrog Group, "Grade A" for Patient Safety for two years in a row - 2012 and 2013. CaroMont Health is located at 2525 Court Drive in Gastonia, N.C., and can be reached at 704.834.2000. Additional information is available at www.caromonthealth.org.
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 approximately 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.
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