Cigna (NYSE:CI) and doctors affiliated with Boulder Community Hospital’s Community
Medical Associates 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 will benefit approximately 4,500 individuals covered by a Cigna
health plan who receive care from among over 80 Community Medical
Associates primary care physicians and specialists.
Collaborative accountable care is Cigna's approach to accomplishing the
same population health goals as accountable care organizations, or ACOs.
The new program is the latest in its efforts to collaborate with
physicians in Colorado to focus on prevention, care coordination and
value. Nearly 45,000 Cigna customers in Colorado now have a physician
practice whose doctors take part in one of six joint collaborative
accountable care programs Cigna has in the state.
“Primary care serves as the first point of contact for a family's
everyday health care needs. Boulder Community Hospital and Community
Medical Associates are fully committed to providing our patients with a
more personal and coordinated approach to medical care,” said Jamie
Jensen, Boulder Community’s COO for physician clinics. “Patients will
benefit from this more collaborative approach that makes them a full
partner in their own health care. While preventive care is important for
everyone, improved coordination of services will be especially valuable
for our most vulnerable populations, those with chronic illnesses or
medically complex conditions.”
“Cigna is committed to supporting these physician practices that put the
patient at the center, with expanded access to care, better coordination
of care, patient education about chronic conditions and wellness, and
access to clinical programs for health improvement,” said Mark Laitos,
M.D., Cigna's senior medical director for Colorado. “Working with
Colorado doctors, we are taking an important step forward in creating a
health care system that rewards physicians for the quality of care they
provide and not just the number of procedures they perform.”
Under the program, doctors monitor and coordinate 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
Community Medical Associates, 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 physician practice 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
that may be available as part of their medical benefits plan. Examples
include disease management programs for diabetes, heart disease and
other conditions, and lifestyle management programs for tobacco
cessation, weight management and stress management.
Cigna will compensate the physician group for the medical and care
coordination services they provide. Additionally, physicians may be
rewarded through a “pay for value” structure for meeting 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 Boulder Community Hospital and Community Medical Associates
Boulder Community Hospital is a coordinated network of facilities and
skilled personnel providing an expansive range of medical services to
people and businesses in Boulder and Broomfield Counties. As a locally
owned and operated non-profit hospital system, Boulder Community is
dedicated to meeting the constantly evolving health care needs of local
citizens. Boulder Community is known across Colorado for its clinical
excellence in heart care, neurosurgery, stroke care, orthopedics and
cancer care. Some 600 physicians in 54 medical specialties have
privileges at BCH. To learn more about BCH, visit www.bch.org.
Community Medical Associates clinics are owned and operated by Boulder
Community Hospital. CMA was established to maintain a strong base of
primary care physicians in the Boulder Valley. The organization has
evolved over time to meet the changing needs of local citizens and now
encompasses a wider range of physician specialties. There are currently
24 CMA clinics located across Boulder and Broomfield counties. All CMA
clinics accept Medicare in recognition of the hospital’s ongoing
commitment to local seniors. To learn more about CMA, visit www.bch.org/physicians.
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