Cigna (NYSE: CI) and two Fairfield County physician groups – PriMed
and Greenwich
Physicians Association, Inc. (or GPA, a Greenwich-based independent
practice association) – have launched collaborative
accountable care initiatives to improve patient access to
health care, enhance care coordination, and achieve the “triple
aim” of improved health, affordability and patient
experience. The programs became effective January 1 and bring to six
the number of Cigna's accountable care initiatives in Connecticut.
Collaborative accountable care is Cigna's approach to
accomplishing the same population health goals as accountable care
organizations, or ACOs. The programs will benefit more than
12,000 individuals covered by a Cigna health plan who receive care from
nearly 200 primary care doctors and specialists affiliated with PriMed
and GPA.
“What motivates our team of health care professionals is that they know
our strength lies within our ability to deliver coordinated, team-based
care, helping our patients to live healthier, more productive lives,”
said Amit Rastogi, M.D., PriMed’s president and CEO. “The collaboration
with Cigna is an opportunity to further our commitment to continuous
improvement with an even greater emphasis on preventive care and patient
outcomes.”
“Through this collaboration with Cigna our doctors have access to more
complete data that will help them provide more coordinated care, which
means more opportunities to improve patient health,” said Glenn
Gandelman, M.D., president of the Greenwich Physicians Association, Inc.
“Better health outcomes and better-satisfied patients are what this
collaboration is all about.”
“When we collaborate with physicians and provide the right incentives
that reward them for results, we have an opportunity to improve the
health care delivery system,” said Dr. Robert Hockmuth, Cigna’s senior
medical executive for Connecticut. “By paying greater attention to the
patient, with a stronger focus on prevention, wellness and care
coordination, we’ll have a healthier population and lower medical costs.
That’s good for individuals, families, employers and health care
professionals.”
Under the program, the medical groups 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 PriMed or GPA 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 or patient
navigators, employed or engaged by the medical groups, 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 groups 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 the medical groups for the medical and care
coordination services they provide. Additionally, the medical groups may
be rewarded through a “pay for value” structure if they meet 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 86
collaborative accountable care initiatives in 27 states,
encompassing more than 880,000 commercial customers and more than 35,000
doctors, including more than 16,000 primary care physicians and more
than 19,000 specialists. Cigna launched its first collaborative
accountable care program in 2008 and will reach its goal 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 more than 250 engaged
physician relationships across 31 states, with more than 62,000 doctors
participating, including more than 22,000 primary care physicians and
more than 40,000 specialists.
About PriMed
PriMed, LLC, formed in 1996, is a multi-specialty physician group of
over 120 health care providers in 36 locations throughout Fairfield and
New Haven Counties. Physician specialties include family medicine,
internal medicine and pediatrics as well as cardiovascular, ear, nose
and throat, endocrinology & diabetes, gastroenterology, general surgery,
infectious disease, nutritional counseling, ophthalmology, physical
therapy, podiatry, pulmonary & sleep medicine, rheumatology & arthritis,
and urology. In addition, PriMed offers ancillary services including
bone mineral density testing, endoscopic testing in a modern, accredited
gastrointestinal suite, sleep disorder treatment and testing at our
accredited sleep center. PriMed also has a full range of cardiac care in
our advanced cardiology center. For more information about our
physicians, services and office locations, visit www.PriMedMD.com.
About The Greenwich Physicians Association
The Greenwich Physicians Association, Inc. (GPA) is an independent
practice association owned and managed by physicians. The GPA was
founded in 1992 and currently includes 106 physician members in 44
medical practices. It is a non-stock corporation governed by a Board of
Directors comprised of community based physicians. The primary purpose
of the GPA is to promote and support the physician members. Specialties
represented among its member physicians include allergy & immunology,
cardiology, endocrinology, reproductive endocrinology, gastroenterology,
infectious diseases, internal medicine, nephrology, neonatology,
neurology, neurosurgery, obstetrics & gynecology, ophthalmology,
otolaryngology, pediatrics, physiatry, pulmonology, radiology and
urology.
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.
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