CIGNA Corporation : Palo Alto Medical Foundation and Cigna Collaborate to Create Cigna's First Accountable Care Program in California
07/17/2012| 01:05pm US/Eastern

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PAMF patients benefit from coordinated care and an increased focus on
preventing medical problems from developing in the first place
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Participating organizations rewarded for improving patient health and
lowering medical costs
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Payment model puts emphasis on quality of care over quantity of care
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Program includes registered nurse clinical care coordinators
Cigna (NYSE:CI) and the Palo
Alto Medical Foundation (PAMF), a not-for-profit health care
organization that is a pioneer in the multispecialty group practice of
medicine, have launched a collaborative accountable care initiative
to expand patient access to health care, improve care coordination,
and achieve the "triple aim" of improved health outcomes (quality),
lower total medical costs and increased patient satisfaction.
Collaborative accountable care is Cigna's approach to accomplishing the
same population health goals as accountable care organizations,
or ACOs.
PAMF is part of the Sutter
Health family of not-for-profit hospitals and physician
organizations that share resources and expertise to advance health care
quality. A pioneer in outpatient medicine, PAMF operates more than 40
individual medical clinics that together serve over 750,000 patients in
communities covering Alameda, San Mateo, Santa Clara and Santa Cruz
counties.
This patient-centered collaboration is Cigna's first accountable
care initiative in California. It links doctors, hospitals and a single
health plan together with the goal of reducing health care costs by
improving patients' health.
The program will benefit as many as 21,000 individuals covered by a
Cigna PPO health plan who receive care from PAMF's more than 1,000
primary and specialty care physicians, including those in its affiliated
independent physician association, Mills-Peninsula Medical Group.
"Cigna is a national leader in accountable care, which is why we are
enthusiastic about working with the company as part of this program,"
says PAMF Chief Executive Officer Richard Slavin, M.D. "We believe this
arrangement offers a wonderful opportunity for us to improve health care
quality, lower medical costs and help our patients lead healthier and
more productive lives.
"PAMF is a pioneer in the adoption of electronic health record
technology to coordinate care, reduce errors and improve communication
between clinicians and patients. These technologically advanced
capabilities make PAMF uniquely suited to a collaborative accountable
care initiative," Dr. Slavin adds.
"It is critical that insurers and health care providers work more
closely together to improve service to patients," says Cecilia Montalvo,
regional vice president of strategy and business development at PAMF and
the Peninsula Coastal Region of Sutter Health. "We believe that by
partnering with Cigna, we are entering into the type of health
plan-health care provider collaboration that will serve as a model for
the future in rewarding innovation and quality of care."
Patients will continue to go to their current physician and will
automatically receive the benefits of the program. There also 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, who serve as
clinical care coordinators to help patients navigate their health care
system. The care coordinators will reach out to patients who are overdue
for important health screenings or who may have skipped a prescription
refill. In addition, patients who may be at increased risk of developing
health problems in the future will be offered preventive services such
as disease management programs for diabetes, heart disease and other
conditions; and lifestyle management programs, such as programs for
tobacco cessation, weight loss and stress management.
This initiative is unique in using data and analytics to focus health
care professionals more fully on engaging patients to improve the
coordination of their care as well as develop best practice clinical
initiatives across all PAMF locations. Cigna will compensate PAMF for
the medical and care coordination services it provides. Additionally,
the organization may be rewarded through a "pay for performance"
structure if it meets its targets for improving quality and lowering
medical costs. Employers who sponsor health plans will benefit from
lower health care costs or health care costs that increase at lower
rates.
"PAMF shares our vision for a patient-centered health care system that
emphasizes prevention and primary care and rewards physicians for care
quality and health outcomes," said Peter B. Welch, president for Cigna
in northern California. "We believe that a system that's focused on
value rather than volume of care offers the best path to improved health
and lower medical costs, which is good for individuals, families,
employers and doctors."
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 medical organizations. Cigna is now engaged in 38
patient-centered initiatives in 19 states, including six multi-payer
medical home pilots and 32 Cigna-only collaborative accountable care
initiatives. The collaborative accountable care initiatives encompass
more than 300,000 Cigna customers and more than 45,000 primary care
physicians.
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 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
and vision care benefits, and other related products including group
disability, life, and accident coverage. Cigna has sales capability in
30 countries and jurisdictions, with approximately 70 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 the Palo Alto Medical Foundation
The Palo Alto Medical Foundation for Health Care, Research and Education
(PAMF) is a not-for-profit health care organization that is a pioneer in
the multispecialty group practice of medicine. PAMF is part of the Sutter
Health family of not-for-profit hospitals and physician
organizations that share resources and expertise to advance health care
quality. Serving more than 100 communities in Northern California,
Sutter Health is a regional leader in cardiac care as well as care of
women and children, and is a pioneer in advanced patient safety and
health information technology.
Photos/Multimedia Gallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50343925&lang=en

Cigna
Mark Slitt, 860-226-2092
mark.slitt@cigna.com
or
Palo
Alto Medical Foundation
Cynthia Greaves, 650-934-8614
GreaveC@pamf.org
© Business Wire 2012
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