DeKalb Physician Hospital Organization Collaborates With Cigna to Improve Health and Lower Costs in Georgia
- Customers 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
DECATUR, Ga., October 13, 2015 - Cigna (NYSE: CI) has launched a collaborative care initiative with DeKalb Physician Hospital Organization (DeKalb PHO) that aims to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. The initiative became effective October 1 and is one of four Cigna collaborative care programs in place in Georgia.
Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The new arrangement will benefit approximately 7,100 people covered by a Cigna health plan who receive care from approximately 120 DeKalb PHO primary care doctors.
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.
"DeKalb PHO looks forward to working collaboratively with Cigna on this program which will further facilitate DPHO's long term efforts to offer innovative approaches to better health care for our patients and community," said Albert Wildstein, M.D., DeKalb PHO's Board Chairman. "Through nurse care coordination, digital health outreach, and enhanced collaboration among physician and hospital providers, we anticipate improved outcomes for the Cigna patients we serve."
"We're excited to expand our collaborative care program further in Georgia and to be working with DeKalb PHO on this health care model that rewards physicians for quality of care, rather than volume of services," said Robert Hamilton, M.D., Cigna's regional medical executive for Georgia. "This new model will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors."
Under the program, DeKalb PHO doctors 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 a DeKalb PHO physician 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 DeKalb PHO, 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 that are part of their employer's health plan.
Cigna will compensate DeKalb PHO for the medical and care coordination services it provides. Additionally, physicians may be rewarded through a "pay for value" structure for meeting 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 134 Cigna Collaborative Care arrangements with large physician groups that span 29 states, reach nearly 1.5 million commercial customers and encompass nearly 60,000 doctors, including approximately 30,000 primary care physicians and 30,000 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 89 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 DeKalb PHO
DeKalb Physician Hospital Organization (DPHO) was incorporated in 1994 as a nonprofit organization to improve the quality and availability of health care services to the community served by DeKalb Medical Center, in Decatur, Georgia and its affiliated physicians and their practices. Today, DPHO continues to carry out that mission by operating as a clinically integrated network of over 500 physicians and the 3 hospitals of DeKalb Medical (DeKalb Medical at North Decatur, DeKalb Medical at Hillandale, and DeKalb Medical at Downtown Decatur) whose primary goal is to work collaboratively to provide coordinated, high-quality, cost-effective patient care with improved outcomes.
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