Adventist Health Network and Cigna Launch Accountable Care Program to Improve Health and Lower Costs in Illinois
- Chicago-area 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
CHICAGO & BLOOMFIELD, Conn., January 23, 2014 - Cigna (NYSE: CI) and Adventist Health Network 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 January 1, 2014 and is Cigna's first collaborative accountable care initiative to launch in Illinois.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit the more than 5,000 individuals covered by a Cigna health plan who receive care from Adventist's 245 primary care physicians and 520 specialists.
"This collaboration with Cigna will play an important role in improving the health of our patients," said George Mayzell, senior chief medical officer with Adventist Midwest Health. "Our partnership will allow us to collaborate on best practices for patient care and engagement, as well as cost management."
Adventist Health Network is a clinically integrated network of community physicians who collaborate with Adventist Midwest Health, including Adventist Bolingbrook, Adventist GlenOaks, Adventist Hinsdale and Adventist La Grange Memorial Hospitals.
"Cigna's relationship with Adventist gives us an opportunity to provide innovative solutions for our customers in the greater Chicago area," said Peter McCauley, M.D., regional medical executive for Cigna's Northeast region, which includes the Midwest. "By rewarding physicians for value, rather than volume of services, we aim to create a patient-centered system focused on prevention and wellness, which will ultimately lead to a healthier population and lower medical costs."
Under the program, Adventist will monitor and coordinate all aspects of an individual's medical care. Patients will continue to be treated by 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, heart disease and obesity.
Critical to the program's success are registered nurses, employed by Adventist Health Network, who will 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, which will ultimately provide 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 will help patients get the follow-up care or screenings they need, identify potential complications related to medications and help 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 Adventist for the medical and care coordination services it provides. Additionally, Adventist may be rewarded through a "pay for value" structure if it meets or surpasses 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 86 collaborative accountable care initiatives in 27 states, encompassing more than 880,000 commercial customers and more than 35,000 doctors, including more than 16,000 primary care physicians and more than 19,000 specialists. Cigna launched its first collaborative accountable care program in 2008 and will reach its goal 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 the innovative Cigna-HealthSpringSM care model for Medicare customers. Today, well over one million Cigna and Cigna-HealthSpring customers benefit from more than 250 engaged physician relationships across 31 states, with more than 62,000 doctors participating, including more than 22,000 primary care physicians and more than 40,000 specialists.
About Adventist Health Network (AHN)
Established in 2004, AHN is a clinically integrated network of community physicians who collaborate with Adventist Midwest Health. The cooperative effort of 800 providers, four hospitals and dozens of ambulatory sites strive for the goals of improving the quality of care and patient experience, improving the health of the entire community and reducing wasteful costs in the health care delivery system.
About Adventist Midwest Health
Adventist Midwest Health is comprised of four hospitals located in the Chicago suburbs of Bolingbrook, Glendale Heights, Hinsdale and La Grange. It began more than 100 years ago, when the Hinsdale Sanitarium was founded by Drs. David and Mary Paulson, Seventh-day Adventist physicians who worked with orphans and the poor in Chicago. Adventist Midwest Health is part of Adventist Health System, a national network of 45 campuses - the largest not-for-profit Protestant hospital system in the country. Adventist Midwest Health is committed to extending the healing ministry of Christ by meeting patients' physical, emotional and spiritual needs.
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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