Cigna (NYSE:CI) and Northwest Physicians Network (NPN), an independent physician association (IPA) serving the south Puget Sound area, 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 nearly 3,300 individuals covered by a Cigna health plan who receive care from NPN’s 150 primary care physicians. The program with NPN is Cigna's first accountable care program in the Puget Sound area and in the state of Washington.
“At NPN, we focus on coordinating the care of our patients to ensure they get the right care at the right place at the right time,” said Patricia Briggs, Northwest Physicians Network CEO. “Our commitment to quality care that delivers superior results for our patients is perfectly aligned 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 Mary O’Neill, M.D., Cigna’s senior medical director for Washington. “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, NPN 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 NPN, 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 NPN 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 Northwest Physicians Network
Northwest Physicians Network is a full service independent practice association that was incorporated in 1995. It has been active in managed care contracts for Medicare and Medicaid populations since is inception. There are about 500 providers representing 51 specialties and sub specialties in the network, which spans a service area of about 1.3 million in the South Puget Sound area of Washington. NPN has been an area leader in providing care management and care coordination services by its nursing staff who work closely with provider offices and hospital personnel. NPN has also sponsored innovative web-based services for its providers, including registries for chronic care improvement and a patient transition of care platform to support care coordination and communication across the community. NPN has become involved in a variety of shared savings programs with commercial payers since 2012. In 2013 NPN and the Franciscan Health System started a joint venture ACO named the Franciscan Northwest Physicians Health Network with a large ACO contract from CMS. To learn more about NPN visit www.npnwa.net.
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.