- Consumers 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
HARTFORD, Conn. ¡V Aug. 26, 2013 - Cigna (NYSE: CI) and Saint Francis HealthCare Partners, a joint venture between Saint Francis Hospital and Medical Center and more than 900 affiliated health care providers, 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 becomes effective October 1, 2013.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit approximately 20,000 individuals covered by a Cigna health plan who receive care from Saint Francis HealthCare Partners¡¦ 216 primary care physicians, 530 specialists and 243 mid-level providers.
The principles of population management achieved through our Accountable Care Organization focus on the patients¡¦ needs by improved care coordination through support of our physicians organized as Patient-Centered Medical Homes and Medical Neighborhoods," said Jess Kupec, president and CEO of Saint Francis HealthCare Partners.
"There¡¦s nothing more important to our medical team than helping our patients stay healthy so they can live their lives to their full potential," Kupec continued. "This collaboration with Cigna is an opportunity to achieve the ¡¥triple aim¡¦ while delivering well-coordinated patient care that results in health improvement."
"We want to fundamentally change the health care delivery system by rewarding physicians for results," said Robert Hockmuth, M.D., Cigna¡¦s senior medical director for Connecticut. "A patientcentered system that¡¦s focused on prevention and wellness, combined with the right incentives for physicians, will ultimately result in a healthier population and lower medical costs. That¡¦s good for individuals, families, employers, doctors, and other healthcare providers."
Under the program, Saint Francis 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 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, heart disease and obesity.
Critical to the program¡¦s benefits are registered nurses, employed by Saint Francis HealthCare Partners, 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 Saint Francis HealthCare Partners for the medical and care coordination services it provides. Additionally, Saint Francis 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 66 collaborative accountable care initiatives in 26 states, encompassing more than 700,000 commercial customers and more than 27,000 doctors, including more than 12,500 primary care physicians and nearly 14,500 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 Cigna-HealthSpringSM care model for Medicare customers. Today, well over one million Cigna and Cigna-HealthSpring customers benefit from these 231 engaged physician relationships across 31 states, with nearly 55,000 doctors participating, including nearly 19,000 primary care physicians and nearly 36,000 specialists.
About Saint Francis HealthCare Partners
Saint Francis HealthCare Partners is a network of independent healthcare practitioners currently serving over 700 physicians in more than 200 medical practices. Over its 20-year history, the organization has been recognized for value and innovation in patient care. Clinical integration is accomplished through the earlyadoption of interactive IT solutions, single-signature-authority contracting and care coordination across the continuum. For more information please visit www.sfhcp.org.
About Saint Francis Hospital and Medical Center
Saint Francis Hospital and Medical Center has been an anchor institution in north central Connecticut since 1897. Licensed for 617 beds and 65 bassinets, it is a major teaching hospital and the largest Catholic hospital in New England. Other major entities of Saint Francis Care include The Mount Sinai Rehabilitation Hospital, the Connecticut Joint Replacement Institute, the Hoffman Heart and Vascular Institute of Connecticut, the Saint Francis/Mount Sinai Regional Cancer Center, the Joyce D. and Andrew J. Mandell Center for Comprehensive Multiple Sclerosis Care and Neuroscience Research. Johnson Memorial Medical Center, parent organization of Johnson Memorial Hospital, Evergreen Health Care Center, and Home and Community Health Services is also a Saint Francis Care Partner. Saint Francis Care¡¦s services are supported by a network of five major Access Centers and eight additional medical office centers sited throughout the region. For more information, visit www.stfranciscare.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 CignaR, including links to follow us on Facebook or Twitter, visit www.cigna.com. ###