Novant Health and Cigna Start Accountable Care Program to Improve Health and Lower Costs
Cigna (NYSE: CI) and Novant
Health, an integrated system of hospitals and physician practices,
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 (CAC) is Cigna's approach to
accomplishing the same population health goals as accountable care
organizations, or ACOs. The program will benefit more than
60,000 individuals covered by a Cigna health plan who receive care from
a Novant Health physician in communities throughout the Carolinas,
making it Cigna's largest CAC nationally. The program with Novant Health
is Cigna's fourth such collaboration in the Carolinas.
“At Novant Health, what’s most important is improving the health of our
communities, one person at a time,” said Carl Armato, chief executive
officer of Novant Health. “We are committed to quality care that
delivers superior results for our patients. We are dedicated to making
their health care experience remarkable so that patients may focus on
what really matters: getting better and staying healthy.
“Coupled with the high number of Novant Medical Group practices that are
certified as patient-centered medical homes by the National Committee
for Quality Assurance (NCQA), the Cigna CAC is a complementary pairing
to keep our focus on patient care and coordination,” stated Armato.
“We’re aiming to fundamentally change the health care delivery system by
rewarding physicians for results,” said Edward Hunsinger, M.D., Cigna’s
senior medical director for the Carolinas. “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, Novant Health 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. In
addition, many patients using Novant Medical Group physicians will be
managed using the EPIC electronic medical record system installed in
practices, as well as have access to My Chart, an electronic patient
access tool that enables patients to communicate with their care team
and review medical records online.
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.
Benefits to Patients
Critical to the program’s benefits are registered nurses, employed by
Novant Health, 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 Novant Health 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 Novant Health
Novant Health is a not-for-profit integrated group of 13 hospitals and a
medical group consisting of 1,124 physicians in 345 clinic locations,
caring for patients and communities in North Carolina, Virginia, South
Carolina and Georgia. Hospitals include the following: Presbyterian
Hospital, Presbyterian Orthopaedic Hospital, Presbyterian Hospital
Matthews and Presbyterian Hospital Huntersville in the Charlotte, NC
area; Forsyth Medical Center and Medical Park Hospital in Winston-Salem,
NC; Kernersville Medical Center, Kernersville, NC; Thomasville Medical
Center, Thomasville, NC; Brunswick Novant Medical Center, Bolivia, NC;
Rowan Regional Medical Center, Salisbury, NC; Franklin Regional Medical
Center, Louisburg, NC; Upstate Carolina Medical Center, Gaffney, SC; and
Prince William Hospital, Manassas, VA. Other Novant facilities and
programs include outpatient surgery centers, medical plazas,
rehabilitation programs, diagnostic imaging centers and community health
outreach programs. Novant Health is ranked 21st nationally
among the 2012 Top 100 Integrated Healthcare Networks, according to an
analysis by the IMS health informatics company.
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 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.
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