First-year results from Cigna's (NYSE:CI) collaborative
accountable care initiative with Granite
Healthcare Network (GHN), a partnership among five independent
charitable health care organizations in New Hampshire, indicate that the
program is making strides toward achieving its goals of improved
health, affordability and patient experience. The
initiative has helped GHN deliver a higher level of care in New
Hampshire while controlling total medical costs for its 30,000 patients
who are covered by a Cigna health plan.
The Granite Healthcare Network comprises Concord Hospital, Elliot Health
System, LRGHealthcare, Southern New Hampshire Health System and
Wentworth-Douglass Hospital. Each member is an independent, integrated
health care delivery system consisting of primary care doctors,
specialists and hospitals. Collaborative accountable care is Cigna's
approach to accomplishing the same population health goals as accountable
care organizations, or ACOs.
When the program started last year, Cigna evaluated how well GHN
followed nationally recognized evidence based medicine guidelines (a
measure of quality) and determined that GHN’s performance was at parity
with the New Hampshire market. In just one year, GHN has improved those
quality results one percent and is now better than the market. This was
driven by improvements in a number of quality measures, including
better-than-market quality results for cervical and breast cancer
screening, adolescent well care, diabetes care and child access to
primary care doctors. In addition, during the first year of the
initiative, GHN improved its rate for closing gaps in care by two
percent.
During the year, GHN’s medical cost trend was 1.2 percentage points
better than the New Hampshire market (GHN 3.7 percent, market 4.9
percent). This successful bending of the cost curve was driven by a
number of factors, including:
-
Emergency room cost trend reduced by 8 percent
-
Emergency room use reduced by 4 percent
-
Advanced imaging (MRI and CT) cost trend reduced by 4 percent
-
Advanced imaging (MRI and CT) use reduced by 7 percent
Very often, patients seek emergency room care when their condition isn’t
an emergency, which drives up the cost of care. Through expanded office
hours and patient education, emergency room use and cost decrease when
patients receive care in the most appropriate setting, such as at the
doctor’s office or an urgent care center.
“We are extremely proud of the dedicated efforts of our medical
directors and physician practices across the region to deliver a higher
level of care to the residents of our communities. Our collaboration
with Cigna, which has been a leader in accountable care in New England
and throughout the country, is helping us deliver high quality care
while keeping health care costs in check,” said Rachel Rowe, executive
director for the Granite Healthcare Network. “While we’re very pleased
with the progress we’ve made so far, we look forward to continuing the
collaboration to the benefit of our patients and Cigna's customers.”
“These remarkable results show that shifting to a system that’s focused
on value rather than volume of care is a viable path to improved health
and lower medical costs, which is good for all stakeholders –
individuals and their families, employers, and the medical community,”
said Donald Curry, president and general manager for Cigna in New
England. “They also show what can be accomplished when a health plan and
a health care delivery system work together with common goals.”
Each of the GHN-participating organizations monitors and coordinates all
aspects of an individual’s medical care. Critical to the program’s
benefits are registered nurses, employed by each of the five GHN health
care organizations, who serve as clinical care coordinators and are
integrated into the care delivery team to help patients with chronic
conditions or other health challenges navigate their health care system.
The care coordinators enhance care by using patient-specific data
provided by Cigna and the electronic medical record to 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
contact these individuals to help them get the follow-up care or
screenings they need, identify any issues related to medications and
help prevent chronic conditions from worsening.
The care coordinators also help patients schedule appointments, provide
health education and refer patients to specialized clinical programs,
such as chronic condition management programs for diabetes, heart
disease and other conditions; and programs that help people quit tobacco
cessation, control their weight or manage stress. More than 30 care
coordinators across GHN have completed specialized training from Johns
Hopkins University as Guided Care Nurses, setting these five health
systems apart from other medical groups across the country.
Cigna provides some compensation to GHN for the medical and care
coordination services its participating organizations provide.
Additionally, the organizations are rewarded through a “pay for value”
structure if they meet their targets for improving quality and lowering
medical costs. Employers who sponsor health plans benefit from lower
health care costs or health care costs that increase at lower rates.
The principles of the patient-centered medical home have been adopted by
GHN’s more than 150 physician practices and 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.
In New England, Cigna has collaborative accountable care arrangements in
Connecticut with Day Kimball Healthcare, New Haven Community Medical
Group, ProHealth Physicians, Inc., Saint Francis HealthCare
Partners and several others that will be announced soon; in Maine with
Central and Western Maine Regional PHO, Kennebec Region Health Alliance,
Martin’s Point Health Care, Mercy Health System and Penobscot Community
Health Care; in Massachusetts with Baycare Health Partners; in New
Hampshire with Dartmouth-Hitchcock Clinic and Derry Medical Center; and
in Vermont with Fletcher Allen Health Care.
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.
About Granite Healthcare Network (GHN)
GHN is a network of charitable organizations that are leading the
transformation of healthcare delivery in New Hampshire by leveraging
their collective intellectual and clinical resources to improve quality,
cost-effectiveness and access beyond what any one of them could achieve
individually. The member hospitals — Concord
Hospital, Elliot
Health System, LRGHealthcare, Southern
New Hampshire Health System, and Wentworth-Douglass
Hospital — have joined forces to implement innovative initiatives
focused on the triple aim of providing better health for communities and
better care for patients at an affordable cost. www.granitehealth.org
Copyright Business Wire 2013