Cigna and Adventist Health Network Experience Early Success Improving Quality and Lowering Costs Through Collaborative Care Program
- Lower medical cost trend compared to market
- Fewer emergency room visits and inpatient hospital admissions for non-emergency care
- Better care coordination for chronic conditions such as asthma and diabetes
CHICAGO, August 19, 2015 - Early results from a collaborative care program between Cigna (NYSE: CI) and Adventist Health Network, NFP show improvement in quality of care and lower medical costs. Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs: improved health, affordability and customer experience.
Cigna's collaborative care program with Adventist Health Network, NFP launched in January 2014, providing cost effective, quality care to more than 5,000 customers covered by a Cigna health plan. After just one year, the program has garnered improvements in several key areas: inpatient hospital admissions, adolescent well care visits, emergency room visits for chronic conditions and medical cost trend.
"We want to help keep people healthy. One of the ways we do this is by working together with groups like Adventist Health Network, NFP to help them coordinate care," said Peter W. McCauley Sr., M.D., regional medical executive for Cigna's Northeast region, which includes the Midwest. "This means identifying people who haven't filled a prescription or who have skipped an important health screening, and giving them tools to manage their health. When we reward doctors for quality care, the customer has a more positive experience and a better health outcome."
Adventist's total medical cost is trending 5.1 percent better than market. Inpatient hospital admissions decreased by 17 percent, a result of improved care coordination between affiliated physicians and better management of chronic conditions such as asthma and diabetes. Additionally, the physician group expanded its network of urgent care facilities, reducing visits to the emergency room for non-emergency care.
The price of advanced imaging, such as CT scans, is a key driver of medical costs and can vary considerably by location. The average cost of CT scans for customers covered by a Cigna health plan who see a provider in Adventist's network was 22 percent lower than market and the average cost of an MRI was 26 percent lower than market.
"With a care coordinator in place and access to data from Cigna, we have been able to help people get the right care, in the right place, at the right time," said George G. Mayzell, M.D., member of Adventist Health Network, NFP's board of directors. "As a result, patients have seen their health improve and their costs decrease."
In places where it's been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reinforcing the appropriate use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.
Critical to the program's benefits are the registered nurse clinical care coordinators, employed by Adventist Health Network, NFP, who help individuals 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 provides a better experience for the individual.
The care coordinators use data from Cigna to help identify individuals being discharged from the hospital who might be at risk for readmission, as well as those 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 help people 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 people schedule appointments, provide health education and refer individuals 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 has been at the forefront of the accountable care organization movement since 2008 and now has 124 Cigna Collaborative Care arrangements with large physician groups that span 29 states, reach more than 1.3 million commercial customers and encompass more than 50,000 doctors, including more than 24,000 primary care physicians and more than 27,000 specialists.
About Adventist Health Network, NFP
Established in 2004, Adventist Health Network, NFP, 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.
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 more than 88 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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