Fairfield County Doctors 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 or patient navigators aligned with Cigna case managers
- Cigna's fifth and sixth accountable care initiatives in Connecticut
HARTFORD, Conn., January 14, 2014 - Cigna (NYSE: CI) and two Fairfield County physician groups - PriMed and Greenwich Physicians Association, Inc. (or GPA, a Greenwich-based independent practice association) - have launched collaborative accountable care initiatives to improve patient access to health care, enhance care coordination, and achieve the "triple aim" of improved health, affordability and patient experience. The programs became effective January 1 and bring to six the number of Cigna's accountable care initiatives in Connecticut.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The programs will benefit more than 12,000 individuals covered by a Cigna health plan who receive care from nearly 200 primary care doctors and specialists affiliated with PriMed and GPA.
"What motivates our team of health care professionals is that they know our strength lies within our ability to deliver coordinated, team-based care, helping our patients to live healthier, more productive lives," said Amit Rastogi, M.D., PriMed's president and CEO. "The collaboration with Cigna is an opportunity to further our commitment to continuous improvement with an even greater emphasis on preventive care and patient outcomes."
"Through this collaboration with Cigna our doctors have access to more complete data that will help them provide more coordinated care, which means more opportunities to improve patient health," said Glenn Gandelman, M.D., president of the Greenwich Physicians Association, Inc. "Better health outcomes and better-satisfied patients are what this collaboration is all about."
"When we collaborate with physicians and provide the right incentives that reward them for results, we have an opportunity to improve the health care delivery system," said Dr. Robert Hockmuth, Cigna's senior medical executive for Connecticut. "By paying greater attention to the patient, with a stronger focus on prevention, wellness and care coordination, we'll have a healthier population and lower medical costs. That's good for individuals, families, employers and health care professionals."
Under the program, the medical groups will monitor and coordinate all aspects of an individual's medical care. Patients will 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 PriMed or GPA doctor 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 benefits are registered nurses or patient navigators, employed or engaged by the medical groups, 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 groups 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 the medical groups for the medical and care coordination services they provide. Additionally, the medical groups may 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 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.
PriMed, LLC, formed in 1996, is a multi-specialty physician group of over 120 health care providers in 36 locations throughout Fairfield and New Haven Counties. Physician specialties include family medicine, internal medicine and pediatrics as well as cardiovascular, ear, nose and throat, endocrinology & diabetes, gastroenterology, general surgery, infectious disease, nutritional counseling, ophthalmology, physical therapy, podiatry, pulmonary & sleep medicine, rheumatology & arthritis, and urology. In addition, PriMed offers ancillary services including bone mineral density testing, endoscopic testing in a modern, accredited gastrointestinal suite, sleep disorder treatment and testing at our accredited sleep center. PriMed also has a full range of cardiac care in our advanced cardiology center. For more information about our physicians, services and office locations, visit www.PriMedMD.com.
About The Greenwich Physicians Association
The Greenwich Physicians Association, Inc. (GPA) is an independent practice association owned and managed by physicians. The GPA was founded in 1992 and currently includes 106 physician members in 44 medical practices. It is a non-stock corporation governed by a Board of Directors comprised of community based physicians. The primary purpose of the GPA is to promote and support the physician members. Specialties represented among its member physicians include allergy & immunology, cardiology, endocrinology, reproductive endocrinology, gastroenterology, infectious diseases, internal medicine, nephrology, neonatology, neurology, neurosurgery, obstetrics & gynecology, ophthalmology, otolaryngology, pediatrics, physiatry, pulmonology, radiology and urology.
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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