Granite Healthcare Network Continues to Improve Quality and Lower Costs Through Cigna Collaborative Care Program
- Medical cost trend of 1.2 percent continues to beat New Hampshire market
- Cervical and breast cancer screening, adolescent well care, diabetes care and child access to primary care doctors are driving quality results
- High compliance with evidence-based medicine guidelines
- Closure rate for gaps in care improved by 8.3 percent
CONCORD, N.H. & BLOOMFIELD, Conn., February 18, 2015 - Second-year results from Cigna's (NYSE: CI) collaborative care initiative with Granite Healthcare Network (GHN), a partnership among five independent charitable health care organizations in New Hampshire, indicate that the program continues to make excellent progress toward achieving the goals 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 initiative has helped GHN deliver a higher level of care in New Hampshire while controlling total medical costs for its more than 27,000 patients who are covered by a Cigna health plan. It is Cigna's largest arrangement of this type in New Hampshire and Northern New England.
Health care systems participating in this initiative for the second year are Concord Hospital, Elliot Health System, LRGHealthcare, Southern New Hampshire Health System and Wentworth-Douglass Hospital. (Catholic Medical Center will join the initiative in April.) GHN is focused on the triple aim of providing better health for communities and better care for their patients at an affordable cost.
The arrangement started in 2012, and during its first year of operation it showed excellent progress. Through close collaboration between Cigna and GHN, the program continues to yield significant improvements in quality and affordability.
With an overall rate of compliance with evidence-based medicine guidelines of 83 percent, GHN's overall quality performance remains better than the New Hampshire market, driven by high quality results for cervical and breast cancer screening, adolescent well care, diabetes care and child access to primary care doctors. Additionally, GHN improved its closure rate for gaps in care by 8.3 percent. (Gaps in care refer to missed prescription refills, overdue screenings or lack of follow-up care for certain medical conditions.)
GHN also had superior results in affordability, with a market-leading 1.2 percent medical cost trend. This was largely driven by a sharp 16.2 percent decrease in avoidable emergency room visits (emergency room visits for non-emergency care), indicating that education and extended office hours are motivating GHN patients to seek care in the most appropriate setting, such as at the doctor's office or an urgent care center. A 1.4% decrease in overall advanced imaging cost per scan (such as CT scans and MRIs) also contributed to the favorable medical cost trend.
"When we started down this path in 2012, we were very confident that our collaboration with Cigna would help us deliver higher quality care while keeping health care costs in check," said Rachel Rowe, executive director for the Granite Healthcare Network. "Our health systems are committed to providing the highest quality care and being recognized as the premier value-based delivery system in the state. It's very satisfying to see that these results from this collaboration are truly making a difference for our patients who put their trust in us every day."
"We congratulate GHN for its commitment to the Cigna Collaborative Care program and for another year of excellent progress," said Mark Butler, president and general manager for Cigna in New England. "These results show what's possible when a health plan and a health care delivery system collaborate to achieve common goals. The winners here are those with a connection to Cigna who use, pay for or deliver health care, including individuals and their families, employers and the medical community."
Each of the GHN-participating organizations monitors and coordinates all aspects of an individual's medical care. Critical to the program's benefits are registered nurses, employed by each of the five GHN health care organizations, who serve as clinical care coordinators and are integrated into the care delivery team to help individuals with chronic conditions or other health challenges navigate their health care system. The care coordinators enhance care by using patient-specific data provided by Cigna and the electronic medical record to identify patients 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 contact these individuals to help them get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.
The care coordinators also help individuals schedule appointments, provide health education and refer patients to specialized clinical programs, such as chronic condition management programs for diabetes, heart disease and other conditions. GHN's patients are also referred to programs that help them quit smoking, control their weight or manage stress. More than 30 care coordinators across GHN have completed specialized training from Johns Hopkins University as Guided Care Nurses, setting these five health systems apart from other medical groups across the country.
Cigna provides some compensation to GHN for the medical and care coordination services its participating organizations provide. Additionally, the organizations are rewarded through a "pay for value" structure if they meet their targets for improving quality and lowering medical costs. Employers who sponsor health plans benefit from lower health care costs or health care costs that increase at lower rates.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 114 Cigna Collaborative Care arrangements with large physician groups that span 28 states, reach more than 1.2 million commercial customers and encompass more than 48,000 doctors, including more than 23,000 primary care physicians and more than 25,000 specialists.
Cigna Collaborative Care is one component of the company's approach to physician engagement for health improvement, which also includes the innovative Cigna-HealthSpring® care model for Medicare customers. Today, more than 1.5 million Cigna and Cigna-HealthSpring customers benefit from nearly 280 engaged physician relationships across 31 states, with more than 79,000 doctors participating, including more than 33,000 primary care physicians and more than 46,000 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 86 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 Granite Healthcare Network (GHN)
GHN is a network of charitable organizations that are leading the transformation of healthcare delivery in New Hampshire by leveraging their collective intellectual and clinical resources to improve quality, cost-effectiveness and access beyond what any one of them could achieve individually. Healthcare systems participating in the Cigna Collaborative Care initiative for the second year are - Concord Hospital, Elliot Health System, LRGHealthcare, Southern New Hampshire Health System, and Wentworth-Douglass Hospital. Catholic Medical Center will join the initiative in April 2015. GHN is focused on the triple aim of providing better health for communities and better care for patients at an affordable cost. Please learn more at www.granitehealth.org.
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