Meritas Health Continues to Improve Quality Through Cigna Collaborative Care Program
- Focus on quality measures, emergency room use, hospital readmissions
- Quality index is 3 percent higher than market and trending better than market
- Screening rates for breast and cervical cancer are better than market
- Non-emergency ER visit rate down 18 percent, hospital readmission rate down 21 percent
KANSAS CITY, Mo., October 05, 2015 - Second-year results from Cigna's (NYSE: CI) collaborative care initiative with Meritas Health, a physician network affiliated with North Kansas City Hospital, indicate that the program continues to make excellent progress toward achieving the goals of improved health, affordability and patient experience.
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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 Meritas deliver a higher level of care to more than 5,000 Cigna customers in the Kansas City area, with a strong emphasis on improved quality, lower use of the emergency room for non-emergencies and reduced hospital readmissions.
For the year ending March 31, 2015, Meritas Health's quality index (a measure of how well doctors follow evidence-based medical guidelines) was 3 percent better than market, which means Meritas Health performed significantly better than other medical practices in the Kansas City area. In addition, the medical group's quality is trending better than the market, which means that Meritas Health continues to improve quality at a faster rate than other medical groups.
There were several factors driving the strong quality index and quality trend results:
- The group's breast cancer screening rate is 7 percent better than market.
- Its cervical cancer screening rate is 4 percent better than market.
- Its overall measure for diabetes care is 7 percent better than market.
Overuse of emergency room (ER) services, especially for non-emergencies, contributes significantly to increased medical costs. Meritas Health took a number of measures to reduce ER use - including extended office hours, patient education and collaboration with hospitals - which produced strong results:
- Overall ER use decreased 8.8 percent from 2014 to 2015.
- Potentially avoidable (non-emergency) ER visits decreased 18 percent from 2013 to 2015.
- ER visits by "frequent users" (three or more visits in a year) decreased 29 percent from 2013 to 2015.
Preventing a hospital readmission after an individual has been discharged is an important measure of care quality and patient satisfaction, and helps rein in medical costs. By focusing on patients at risk for readmission and ensuring that patients being discharged have a treatment plan and arrangements for follow-up care enabled Meritas Health to lower its readmission rate by 21 percent from 2013 to 2015.
"We're thrilled that we've had such strong results, which we've been able to achieve through the hard work and dedication of our clinical team, including our care coordinator, who all play a vital role in this program; and through close collaboration with Cigna," said Linda Coventon, Meritas Network Executive.
"We congratulate Meritas Health for its commitment to Cigna Collaborative Care and for its strong focus on quality improvement," said Jack Davidson, M.D., senior medical director for Cigna in the Mid-America market. "These results show what's possible when a health plan and health care professionals collaborate to achieve common goals: better health and a better experience for the people we jointly serve."
Critical to the program's benefits is the Meritas Health nurse who serves as clinical care coordinator and helps patients with chronic conditions or other health challenges navigate the health care system. The care coordinator is aligned with a team of Cigna case managers to ensure a high degree of collaboration between the Meritas Health physicians and Cigna that ultimately results in a better experience for the individual.
The care coordinator enhances care by using patient-specific data from Cigna to help identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinator is part of the physician-led care team that helps patients get the follow-up care or screenings they need, identifies potential complications related to medications and helps prevent chronic conditions from worsening.
The care coordinator can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support programs that may be available to them through their employer's benefit plan.
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 Meritas Health
Meritas Health Corporation, a wholly owned subsidiary of North Kansas City Hospital, was formed in 1994 to ensure the stability of primary care physician services to meet the needs of the community and has expanded to sub-specialty areas where there is an identified need. Meritas is comprised of more than 115 physicians in 30 locations including specialties in family practice, internal medicine, pediatrics, obstetrics/gynecology, cardiology, surgery, ENT, neurology, pulmonology, endocrinology, neurosurgery, psychiatry and occupational medicine. Meritas Health is the Northland's largest network of physicians.
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