CIGNA CORPORATION Cigna (NYSE: CI) and Providence Medical Group – Oregon have launched a collaborative care initiative to improve access to health care, enhance care coordination, and achieve the goal of improved health, affordability and customer experience. The program became effective January 1.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit 7,000 individuals covered by a Cigna health plan who receive care from over 800 Providence Medical Group primary and specialty care physicians.
In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while holding the line on medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reducing unnecessary 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.
“This initiative will help us focus on prevention, screening and early intervention at all times and provide the highest quality of evidence-based care when needed, helping to ease the way and improve the health of our patients,” said Ben LeBlanc, M.D., chief medical officer for Providence Medical Group in Oregon.
“This collaboration presents an excellent opportunity to help transform the health care delivery system,” said John Sobeck, M.D., Cigna’s market medical executive for the Pacific Northwest. “When we reward doctors for results and focus on prevention, we improve health care quality, lower costs and deliver a better customer experience.”
Under the program, Providence Medical Group will provide care coordination services to support, monitor and coordinate all aspects of an individual’s medical care. People will continue to go to their current Providence Medical Group 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 Providence Medical Group doctor will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Individuals 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 Providence Medical Group, who will help people 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 people being discharged from the hospital who might be at risk for readmission, as well as those 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 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 people schedule appointments, provide health education and refer individuals 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 Providence Medical Group for the medical and care coordination services it provides. Additionally, the physician group may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 114 Cigna Collaborative Care arrangements with large physician groups that span 28 states, reach more than 1.2 million commercial customers and encompass more than 48,000 doctors, including more than 23,000 primary care physicians and more than 25,000 specialists.
Cigna Collaborative Care is one component of the company's approach to physician engagement for health improvement, which also includes the innovative Cigna-HealthSpring® care model for Medicare customers. Today, more than 1.5 million Cigna and Cigna-HealthSpring customers benefit from nearly 280 engaged physician relationships across 31 states, with more than 79,000 doctors participating, including more than 33,000 primary care physicians and more than 46,000 specialists.
About Providence Medical Group
Providence Medical Group is part of Providence Health & Services in Oregon, which offers a comprehensive array of health and education services through its eight hospitals, medical clinics, health plans, long-term care facilities and home health services. With more than 18,000 employees, Providence is the state’s largest private employer. Visit www.providence.org/oregon.
About Cigna
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 85 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
