Cigna (NYSE: CI) and Santa
Clara County IPA (SCCIPA) 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, and is Cigna's
third accountable care initiative in the Bay Area.
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
13,000 individuals covered by a Cigna PPO health plan who receive care
from SCCIPA’s 850 primary care doctors and specialists.
“What matters to our physicians is delivering well-coordinated care that
helps our patients live healthier, more productive lives. My family has
personally seen the benefit of physicians working with a Cigna case
manager,” said J. Kersten Kraft, M.D., president of SCCIPA. “Through
this collaboration with Cigna we hope to go one step further by placing
even greater emphasis on quality and results, so that our patients can
live their lives to their full potential.”
“Our aim is to change the health care delivery system for the better by
focusing on both the patient and the physician,” said Peter B. Welch,
Cigna’s president and general manager for northern California. “When we
emphasize prevention, wellness and better care coordination, and provide
physicians with the right incentives, we’ll have a healthier population
and lower medical costs. That’s good for individuals, families,
employers and health care professionals.”
Under the program, SCCIPA will monitor and coordinate all aspects of an
individual’s medical care. Patients will 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 SCCIPA doctor 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 benefits are registered nurses, employed by
SCCIPA, 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 SCCIPA for the medical and care coordination
services it provides. Additionally, SCCIPA 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 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.
About Santa Clara County IPA
SCCIPA is the largest individual practice association in Santa Clara
County with 850 physicians in more than 60 specialties. SCCIPA,
physician-owned and governed, is dedicated to supporting and maintaining
independent physician practices. To learn more about SCCIPA visit www.SCCIPA.com.
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 80 million customer relationships
throughout the world. To learn more about Cigna®, including links to
follow us on Facebook or Twitter, visit www.cigna.com.
Copyright Business Wire 2013