Greater Baltimore Health Alliance and Cigna Start Accountable Care Program to Improve Health and Lower Costs
- Consumers benefit from improved care coordination and greater emphasis on preventive care
- Greater Baltimore Health Alliance doctors are rewarded for improving patient health and lowering medical costs
- Program includes registered nurse care coordinators aligned with Cigna case managers
BALTIMORE, April 03, 2013 - Cigna (NYSE:CI) and the Greater Baltimore Health Alliance have launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the "triple aim" of improved health (quality), affordability and patient satisfaction.
Greater Baltimore Health Alliance is an accountable care organization of employed and community-based physicians affiliated with GBMC HealthCare system, parent company of the Greater Baltimore Medical Center hospital. The program, Cigna's first collaborative accountable care initiative in Maryland, became effective April 1.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit approximately 3,000 individuals covered by a Cigna health plan who receive care from among more than 90 Greater Baltimore Health Alliance physicians practicing at 17 locations in central Maryland.
"Our vision is to become the health care system where everyone, every time gets the care that we would want for our own loved ones -- the best possible health outcomes, with the best possible care experience, with the most joy for those providing the care, at the lowest possible cost," said Mark Lamos, M.D., Medical Director, Greater Baltimore Health Alliance. "Through our collaboration with Cigna, we are working to transform care to be better coordinated and to increase value through the eyes of the patient."
Under the program, Greater Baltimore Health Alliance physicians 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. 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.
"With Greater Baltimore Health Alliance, we are working to build a patient-centered health care system that emphasizes prevention and primary care and rewards physicians for quality of care and improved health," said Julia Huggins, president and general manager, Cigna MidAtlantic. "A system that's focused on value rather than volume will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors."
Critical to the program's benefits are registered nurses, employed by Greater Baltimore Health Alliance, 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 health alliance physicians 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 that may be available to them through their employer benefit plan.
Cigna will compensate Greater Baltimore Health Alliance physicians for the medical and care coordination services they provide. Additionally, physicians may be rewarded through a "pay for value" structure for meeting 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 is now engaged in nearly 60 collaborative accountable care initiatives in 24 states, encompassing more than 650,000 Cigna customers and more than 23,000 doctors, including more than 11,000 primary care physicians and more than 11,500 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.
About Greater Baltimore Health Alliance
The Greater Baltimore Health Alliance (GBHA) is a wholly owned Limited Liability Company (LLC) of GBMC Healthcare, Inc. It was created to align health care providers and achieve a triple aim of Better Health, Better Care and Less Waste. GBHA has successfully brought more than 90 primary care providers together to participate in the Centers for Medicare and Medicaid's (CMS) Shared Savings Program. GBHA includes providers from 8 independent practices, Greater Baltimore Medical Associates (GBMA), and Greater Baltimore Geriatric and Palliative Medicine. The Greater Baltimore Health Alliance is one of only 260 Accountable Care Organizations in the nation. It is one of eight operating in the State of Maryland and the first ACO in Maryland associated with a hospital.
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 78 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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