Cumberland Center for Healthcare Innovation and Cigna Launch Accountable Care Program in Tennessee to Improve Health and Lower Costs
- Consumers benefit from improved care coordination and greater emphasis on preventive care
- Physicians are rewarded for improving patient health and lowering medical costs
- Program includes registered nurse care coordinators aligned with Cigna case managers
COOKEVILLE, Tenn. & BLOOMFIELD, Conn., January 28, 2014 - Cigna (NYSE: CI) and the Cumberland Center for Healthcare Innovation (CCHI) ACO 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.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program, which took effect January 1, 2014, will benefit more than 2,900 individuals covered by a Cigna health plan who receive care from among 37 independent physician practices, located primarily in Cookeville and nearby areas of Middle Tennessee, that are part of CCHI.
"CCHI is very excited about the collaboration with Cigna. Our physicians are committed to providing Cigna customers with care centered on evidence-based models," said Eric Bletzinger, chief executive officer of Cumberland Center for Healthcare Innovation. "CCHI firmly believes this approach will best benefit patients and provide long-term savings for their employers."
"This group of physicians understands the value of collaboration between doctors and the health plan and has built a strong culture of coordinating care across medical practices," said Renee McLaughlin, M.D., Cigna's senior medical director for Tennessee. "This model benefits both patients and local employers, who can enjoy better care and lower medical costs through these efforts."
Under the program, CCHI physicians 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 one of the CCHI practices will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists and no additional costs to patients. 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, affiliated with CCHI and its 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 are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the physician practices 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 and wellness programs that may be available through their employer's benefit plans.
CCHI was introduced to the Cigna program by Atlanta-based Reliance Consulting Group, which continues to work with the two organizations to facilitate their collaboration. "This is a great example of how a new Medicare ACO is building an efficient and sustained operation through multi-payer financing," said John Schmitt, president of Reliance Consulting Group.
Cigna will compensate CCHI physicians for the medical and care coordination services they provide. Additionally, doctors may be rewarded through a "pay for value" structure for meeting or exceeding targets for improving quality and lowering medical costs.
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 Cumberland Center for Healthcare Innovation
Cumberland Center for Healthcare Innovation is a new government-funded Accountable Care Organization in Cookeville, Tennessee. CCHI was selected as an Advanced Payment (AP) Medicare Shared Savings Program (MSSP) ACO model by the CMS Innovation Center. Comprised of 37 medical practices in the region, Cumberland Center coordinates transforming clinical patient care and clinical quality to close gaps in patient care.
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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