Cigna and Providence-Swedish Health Alliance ACO Partner to Improve Quality and Lower Medical Costs
- Customers benefit from improved care coordination and greater emphasis on preventive care
- Physicians are rewarded for improving customer health and lowering medical costs
- Program includes registered nurse care managers aligned with Cigna case managers
BLOOMFIELD, Conn., July 08, 2015 - Cigna (NYSE: CI) and Providence-Swedish Health Alliance ACO in Western Washington have launched a collaborative care initiative that aims to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience.
Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program with Providence Swedish Health Alliance will benefit more than 7,100 individuals covered by a Cigna health plan who receive care from more than 1500 ACO providers.
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.
"I am excited to be adding Providence-Swedish Health Alliance to our CCC portfolio. Providence-Swedish Health Alliance shares our vision of changing the health care delivery system from one that rewards volume of care to one that puts the patient at the center and rewards quality of outcomes and value," said John Sobeck, M.D., Cigna's senior medical director.
Under the program, Providence-Swedish Health Alliance will monitor and coordinate all aspects of an individual's medical care. Patients will continue to go to their current physicians and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from Providence-Swedish Health Alliance 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 the registered nurse clinical care coordinators, employed by Providence-Swedish Health Alliance who will 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 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 individuals being discharged from the hospital who might be at risk for readmission, as well as individuals who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators are part of physician-led care teams that will 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 individuals schedule appointments, provide health education and refer people 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 Providence-Swedish Health Alliance for the medical and care coordination services it provides. Additionally, the physician group may be rewarded through a "pay for value" structure if it meets targets for improving quality and lowering medical costs.
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.
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.
About Providence-Swedish Health Alliance
The Providence-Swedish Health Alliance is an accountable care organization (ACO) offering a transformative approach to health care and benefits. By bringing physicians, hospitals and other partners together to more closely coordinate care for patients, the ACO focuses on delivering the highest quality care to patients at a lower cost. The Providence-Swedish Health Alliance includes the comprehensive resources of Providence Health & Services, Swedish Health Services, Minor & James Medical and Pacific Medical Centers. The Providence-Swedish Health Alliance was approved as a Medicare ACO in December 2013 and serves more than 25,000 Medicare beneficiaries in Western Washington.
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