Cigna (NYSE: CI) and Adventist
Health Network 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 January 1, 2014 and is Cigna's first
collaborative accountable care initiative to launch in Illinois.
Collaborative accountable care is Cigna's approach to
accomplishing the same population health goals as accountable care
organizations, or ACOs. The program will benefit the more
than 5,000 individuals covered by a Cigna health plan who receive care
from Adventist’s 245 primary care physicians and 520 specialists.
“This collaboration with Cigna will play an important role in improving
the health of our patients,” said George Mayzell, senior chief medical
officer with Adventist Midwest Health. “Our partnership will allow us to
collaborate on best practices for patient care and engagement, as well
as cost management.”
Adventist Health Network is a clinically integrated network of community
physicians who collaborate with Adventist Midwest Health, including
Adventist Bolingbrook, Adventist GlenOaks, Adventist Hinsdale and
Adventist La Grange Memorial Hospitals.
“Cigna's relationship with Adventist gives us an opportunity to provide
innovative solutions for our customers in the greater Chicago area,”
said Peter McCauley, M.D., regional medical executive for Cigna's
Northeast region, which includes the Midwest. “By rewarding physicians
for value, rather than volume of services, we aim to create a
patient-centered system focused on prevention and wellness, which will
ultimately lead to a healthier population and lower medical costs.”
Under the program, Adventist will monitor and coordinate all aspects of
an individual’s medical care. Patients will continue to be treated by
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, heart disease and obesity.
Critical to the program’s success are registered nurses, employed by
Adventist Health Network, 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 Adventist for the medical and care coordination
services it provides. Additionally, Adventist may be rewarded through a
“pay for value” structure if it meets or surpasses 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 Adventist Health Network (AHN)
Established in 2004, AHN is a clinically integrated network of community
physicians who collaborate with Adventist Midwest Health. The
cooperative effort of 800 providers, four hospitals and dozens of
ambulatory sites strive for the goals of improving the quality of care
and patient experience, improving the health of the entire community and
reducing wasteful costs in the health care delivery system.
About Adventist Midwest Health
Adventist Midwest Health is comprised of four hospitals located in the
Chicago suburbs of Bolingbrook, Glendale Heights, Hinsdale and La
Grange. It began more than 100 years ago, when the Hinsdale Sanitarium
was founded by Drs. David and Mary Paulson, Seventh-day Adventist
physicians who worked with orphans and the poor in Chicago. Adventist
Midwest Health is part of Adventist Health System, a national network of
45 campuses – the largest not-for-profit Protestant hospital system in
the country. Adventist Midwest Health is committed to extending the
healing ministry of Christ by meeting patients’ physical, emotional and
spiritual needs.
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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