ROCKY MOUNT, N.C. & BLOOMFIELD, Conn., October 16, 2013 – Cigna (NYSE: CI) and the Boice-Willis Clinic, one of the largest and oldest multi-specialty, physician-owned practices in Eastern North Carolina, 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, 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 individuals covered by a Cigna health plan who receive care from the Boice-Willis Clinic’s 30 primary care doctors, 27 specialists and five health educators.
“The collaboration with Cigna aligns with the Clinic’s mission to provide comprehensive care and improve patient access to health care,” said Gary J. Fazio, Boice-Willis Clinic’s chief executive officer. “This program demonstrates Cigna and the Clinic’s team approach to proactive and ongoing management of patient needs.”
“We’re thrilled to continue expanding our collaborative accountable care program across the Carolinas with the addition of the Boice-Willis Clinic,” said Edward Hunsinger, M.D., Cigna’s senior medical executive for the Carolinas. “This collaboration aims to change the health care delivery system from one that focuses on volume to one that rewards physicians for quality care. Our mutual goal of creating a patient-centered system focused on prevention and wellness will result in a healthier population and lower medical costs.”
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Under the program, Boice-Willis will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to be treated by 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 success are registered nurses, employed by the Boice-Willis Clinic, 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 the Boice-Willis Clinic for the medical and care coordination services it provides. Additionally, Boice-Willis may be rewarded through a “pay for value” structure if it meets or surpasses 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.
Date: 16 October 2013