Cigna (NYSE:CI) and Atlantic Accountable Care Organization, 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 is effective April 1.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 15,000 individuals covered by a Cigna health plan who receive care from Atlantic ACO’s 1,300 physicians.
“Every day our doctors and clinical team focus on providing well-coordinated care that helps our patients live healthier, more productive lives,” said David Shulkin, M.D., administrator, Atlantic ACO, president, Morristown Medical Center, and vice president, Atlantic Health System. “Our commitment to quality care that delivers superior results for our patients aligns with Cigna's commitment to changing the focus of health care from volume of care to quality and value of care.”
“We’re aiming to fundamentally change the health care delivery system by rewarding physicians for results,” said Ronald Menzin, M.D., Cigna’s senior medical director for New Jersey. “A patient-centered 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 and doctors.”
Under the program, Atlantic ACO monitors and coordinates 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 Atlantic ACO, 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 medical group 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, 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 Atlantic ACO for the medical and care coordination services it provides. Additionally, the medical group 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 is now engaged in nearly 60 collaborative accountable care initiatives in 24 states, encompassing more than 650,000 Cigna customers and more than 23,000 doctors, including more than 11,000 primary care physicians and more than 11,500 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.
About Atlantic Accountable Care Organization
Touted as one of the “10 ACOs to Know” by Becker’s Hospital Review, the Atlantic ACO was one of the first and largest in the country selected to participate in the Medicare Shared Savings Program Accountable Care Organization, a multifaceted program sponsored by the Centers for Medicare and Medicaid Services. Atlantic ACO includes participation from more than 1,300 physicians, including more than 200 primary care physicians, 50 nurse practitioners and 10 ancillary care providers in five counties: Bergen, Morris, Sussex, Somerset, and Union counties. Through its participating physicians, hospitals, and staff, Atlantic ACO is committed to improving the quality of health care and reducing the individual and clinical health care costs for the population served in these regions. Atlantic ACO cares for more than 55,000 beneficiaries.
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 78 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.