Valley Preferred and Cigna Start Accountable Care Program
LEHIGH VALLEY, Pa. and BLOOMFIELD, Conn. – June 24, 2013 – Cigna (NYSE: CI) and Valley Preferred are launching 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, Cigna's first collaborative accountable care initiative to launch in Pennsylvania, is effective July 1.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit approximately 5,500 individuals covered by a Cigna health plan who receive care from Valley Preferred primary care and specialty physicians.
“Valley Preferred is pleased to partner with Cigna in this innovative care coordination effort to enhance patient engagement and overall population health,” said Dr. Jack Lenhart, executive director, Valley Preferred. “Together, Valley Preferred physicians and care coordinators, along with Cigna, will work to achieve measureable improvements in patient care and sustainability of community health.”
“We need a patient-centered health care system that emphasizes prevention and primary care, and rewards physicians for quality of care and outcomes,” said Julia Huggins, Cigna president and general manager for Pennsylvania. “A system that’s focused on value rather than volume will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors.”
Under the program, Valley Preferred physicians 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 Valley Preferred physician 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 Valley Preferred registered nurses 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 employee 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 Valley Preferred physicians for the medical and care coordination services they provide. Additionally, they 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. Effective July 1, Cigna will have 66 collaborative accountable care initiatives in 26 states, encompassing more than 700,000 commercial customers and more than 27,000 doctors, including more than 12,500 primary care physicians and nearly 14,500 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 Cigna-HealthSpring’s care model for Medicare customers. Taken together, these 231 programs in 31 states reach more than one million customers and have nearly 19,000 participating primary care physicians.
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.