SAN JOSE, Calif.--(EON: Enhanced Online News)--Cigna (NYSE: CI) and Santa Clara County IPA (SCCIPA) have launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination, and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective October 1, and is Cigna's third accountable care initiative in the Bay Area.
“When we emphasize prevention, wellness and better care coordination, and provide physicians with the right incentives, we’ll have a healthier population and lower medical costs. That’s good for individuals, families, employers and health care professionals.”
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 13,000 individuals covered by a Cigna PPO health plan who receive care from SCCIPA’s 850 primary care doctors and specialists.
“What matters to our physicians is delivering well-coordinated care that helps our patients live healthier, more productive lives. My family has personally seen the benefit of physicians working with a Cigna case manager,” said J. Kersten Kraft, M.D., president of SCCIPA. “Through this collaboration with Cigna we hope to go one step further by placing even greater emphasis on quality and results, so that our patients can live their lives to their full potential.”
“Our aim is to change the health care delivery system for the better by focusing on both the patient and the physician,” said Peter B. Welch, Cigna’s president and general manager for northern California. “When we emphasize prevention, wellness and better care coordination, and provide physicians with the right incentives, we’ll have a healthier population and lower medical costs. That’s good for individuals, families, employers and health care professionals.”
Under the program, SCCIPA will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physician 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 SCCIPA doctor 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 registered nurses, employed by SCCIPA, who will serve as clinical care coordinators and 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 medical 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 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 coordinators are part of the physician-led care team that will help patients 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 patients schedule appointments, provide health education and refer patients 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 SCCIPA for the medical and care coordination services it provides. Additionally, SCCIPA may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.
The principles of the patient-centered medical home are the foundation of Cigna's collaborative accountable care initiatives. Cigna then builds on that foundation with a strong focus on collaboration and communication with physician practices. Cigna has 75 collaborative accountable care initiatives in 26 states, encompassing more than 760,000 commercial customers and more than 30,000 doctors, including more than 14,000 primary care physicians and more than 16,500 specialists. Cigna launched its first collaborative accountable care program in 2008 and its goal is to have 100 of them in place with one million customers in 2014.
Collaborative accountable care is one component of the company's approach to physician engagement for health improvement, which also includes the innovative Cigna-HealthSpringSM care model for Medicare customers. Today, well over one million Cigna and Cigna-HealthSpring customers benefit from 240 engaged physician relationships across 31 states, with more than 58,000 doctors participating, including more than 20,000 primary care physicians and nearly 38,000 specialists.
About Santa Clara County IPA
SCCIPA is the largest individual practice association in Santa Clara County with 850 physicians in more than 60 specialties. SCCIPA, physician-owned and governed, is dedicated to supporting and maintaining independent physician practices. To learn more about SCCIPA visit www.SCCIPA.com.
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 approximately 80 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.