Lahey Clinical Performance Network Collaborates With Cigna to Improve Health and Lower Costs in Boston Area
- Customers 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 aligned with Cigna case managers
- Lahey to benefit from Cigna's consultative services and national ACO best practices sharing
- Cigna's first arrangement of this type in Boston area
BOSTON, October 19, 2015 - Cigna (NYSE: CI) has launched a collaborative care initiative with Lahey Clinical Performance Network 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 Cigna's first arrangement of this type in the Boston area.
Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The arrangement will benefit nearly 7,000 individuals covered by a Cigna administered health plan who receive care from the 850 Lahey Clinical Performance Network doctors who are affiliated with Lahey Hospital & Medical Center, Beverly Hospital, Addison Gilbert Hospital and Winchester Hospital.
In places where it's been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. For example, programs in place for two or more years have, on average, 2 percent lower-than-market total medical cost and 2 percent better-than-market quality. 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.
"We established Lahey Clinical Performance Network to provide highly-coordinated, cost-effective care that would improve the health of our patients and deliver a superior patient experience," said Greg Bazylewicz, M.D., senior vice president, chief population health officer & president of the Lahey Clinical Performance Network (LCPN). "We look forward to collaborating with Cigna as we strive to better serve our patients."
"We've had great success with these types of arrangements throughout New England and throughout the country, and we're thrilled that Lahey Clinical Performance Network has joined Cigna Collaborative Care in a consultative partnership with us," said Mark Butler, Cigna's president and general manager for New England. "When we reward doctors for the value of their care and focus on prevention, wellness, health improvement and care coordination, we can create a system that works for everyone who uses, pays for or delivers health care."
Under the program, Lahey Clinical Performance Network 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 administered health plan and later choose to seek care from Lahey Clinical Performance Network 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 Lahey Clinical Performance Network, 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.
In addition to reimbursement for the medical and care coordination services it provides, the Lahey Clinical Performance Network may be rewarded through a "pay for value" structure if it meets targets for improving quality and lowering medical costs.
Cigna clinical and medical economics teams will provide ongoing consultative services to Lahey Clinical Performance Network to help the medical group achieve its quality and financial targets. Lahey Clinical Performance Network will also benefit from the learning collaboratives that Cigna convenes each quarter, which enable front line staff from more than 100 Cigna Collaborative Care participating medical groups nationwide to share best practices and success stories.
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. They 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 Lahey Clinical Performance Network
Lahey Clinical Performance Network (LCPN) is responsible for providing population health management services, including care coordination, total medical expense management and provider office services for a focused patient population with complex medical needs who are affiliated with Lahey Health System (LHS). LCPN utilizes Care Managers from multiple disciplines, including registered nurses, pharmacists, social workers and health coaches who work closely with primary care physicians to provide individualized support for patients when they are in the greatest need of care coordination.
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