Meritas Health and Cigna Start Accountable Care Program to Improve Health and Lower Costs
- Consumers benefit from improved care coordination and greater emphasis on preventive care
- Meritas Health doctors are rewarded for improving patient health and lowering medical costs
- Program includes nurse care coordinators aligned with Cigna case managers
KANSAS CITY, Mo., April 03, 2013 - Cigna (NYSE:CI) and Meritas Health, a physician network affiliated with North Kansas City Hospital 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 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 5,300 individuals covered by a Cigna health plan who receive care from among 82 Meritas Health primary care and specialty physicians practicing at 23 Kansas City locations.
"Improving the health of patients and our community is our mission and in Cigna, we have found a like-minded organization to work with to achieve this goal," said Linda Coventon, Meritas Health network executive. "Our collaboration brings together the clinical expertise of our physicians and Cigna's information and care management resources to enhance patient satisfaction and to improve care quality and cost results."
Under the program, Meritas Health 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.
"Meritas Health is working to provide more value to patients and local employers by better coordinating care, which leads to better health and reduced costs," said Frank Monahan, president and general manager for Cigna in Mid-America markets including Missouri. "They are an ideal organization for us to work with to change the health care system from one that focuses on volume of care to one that rewards the value of that care."
Critical to the program's benefits are Meritas Health nurses, 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 Meritas Health 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's benefit plan.
Cigna will compensate Meritas Health physicians for the medical and care coordination services they provide. Additionally, physicians will be rewarded through a "pay for value" structure if they meet 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 Meritas Health
Meritas Health Corporation, a wholly owned subsidiary of North Kansas City Hospital, was formed to ensure the stability of primary care physician services to meet the needs of the community and has expanded to sub-specialty areas where there is an identified need. Meritas is comprised of 82 physicians including specialties in family practice, internal medicine, pediatrics, obstetrics/gynecology, cardiology, surgery, ENT, integrative medicine, and occupational medicine.
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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