BOULDER, Colo.--(EON: Enhanced Online News)--Cigna (NYSE:CI) and doctors affiliated with Boulder Community Hospital’s Community Medical Associates 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 will benefit approximately 4,500 individuals covered by a Cigna health plan who receive care from among over 80 Community Medical Associates primary care physicians and specialists.
“Primary care serves as the first point of contact for a family's everyday health care needs. Boulder Community Hospital and Community Medical Associates are fully committed to providing our patients with a more personal and coordinated approach to medical care”
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The new program is the latest in its efforts to collaborate with physicians in Colorado to focus on prevention, care coordination and value. Nearly 45,000 Cigna customers in Colorado now have a physician practice whose doctors take part in one of six joint collaborative accountable care programs Cigna has in the state.
“Primary care serves as the first point of contact for a family's everyday health care needs. Boulder Community Hospital and Community Medical Associates are fully committed to providing our patients with a more personal and coordinated approach to medical care,” said Jamie Jensen, Boulder Community’s COO for physician clinics. “Patients will benefit from this more collaborative approach that makes them a full partner in their own health care. While preventive care is important for everyone, improved coordination of services will be especially valuable for our most vulnerable populations, those with chronic illnesses or medically complex conditions.”
“Cigna is committed to supporting these physician practices that put the patient at the center, with expanded access to care, better coordination of care, patient education about chronic conditions and wellness, and access to clinical programs for health improvement,” said Mark Laitos, M.D., Cigna's senior medical director for Colorado. “Working with Colorado doctors, we are taking an important step forward in creating a health care system that rewards physicians for the quality of care they provide and not just the number of procedures they perform.”
Under the program, doctors monitor and coordinate all aspects of an individual’s medical care. Patients 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 doctor in the medical group 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 or heart disease.
Critical to the program’s benefits are registered nurses, employed by Community Medical Associates, who 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 physician practice and Cigna that ultimately results in 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 helps patients get the follow-up care or screenings they need, identifies potential complications related to medications and helps 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 that may be available as part of their medical benefits plan. Examples include disease management programs for diabetes, heart disease and other conditions, and lifestyle management programs for tobacco cessation, weight management and stress management.
Cigna will compensate the physician group for the medical and care coordination services they provide. Additionally, physicians may be rewarded through a “pay for value” structure for meeting 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 Boulder Community Hospital and Community Medical Associates
Boulder Community Hospital is a coordinated network of facilities and skilled personnel providing an expansive range of medical services to people and businesses in Boulder and Broomfield Counties. As a locally owned and operated non-profit hospital system, Boulder Community is dedicated to meeting the constantly evolving health care needs of local citizens. Boulder Community is known across Colorado for its clinical excellence in heart care, neurosurgery, stroke care, orthopedics and cancer care. Some 600 physicians in 54 medical specialties have privileges at BCH. To learn more about BCH, visit www.bch.org.
Community Medical Associates clinics are owned and operated by Boulder Community Hospital. CMA was established to maintain a strong base of primary care physicians in the Boulder Valley. The organization has evolved over time to meet the changing needs of local citizens and now encompasses a wider range of physician specialties. There are currently 24 CMA clinics located across Boulder and Broomfield counties. All CMA clinics accept Medicare in recognition of the hospital’s ongoing commitment to local seniors. To learn more about CMA, visit www.bch.org/physicians.
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.