DENVER--(BUSINESS WIRE)--Cigna (NYSE: CI) and Physician Health Partners 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 includes Denver-area doctors affiliated with Primary Physician Partners and South Metro Primary Care.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit over 27,000 individuals covered by a Cigna health plan who receive care from among over 300 primary care physicians affiliated with the two medical groups.
“Physician Health Partners and our affiliated primary care physicians are excited to be involved in the accountable care movement and to bring a new level of health care quality to our patients,” said Kenneth Nielsen, President and CEO, Physician Health Partners.
“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.”
The new program is the latest in Cigna's efforts to collaborate with physicians in Colorado to focus on prevention, care coordination and value. Over 75,000 Cigna customers in Colorado now have a physician practice whose doctors take part in one of nine joint collaborative accountable care programs Cigna has in the state. Cigna currently has 86 similar programs across the country.
Under the program, doctors with Primary Physician Partners and South Metro Primary Care 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 one of the medical groups 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 and social workers, employed by Physician Health Partners, who are part of the physician-led care team and serve as clinical care coordinators. They help patients with chronic conditions or other health challenges navigate the health care system. For example, they identify patients discharged from the hospital who might be at risk for readmission, help patients 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 use patient-specific data from Cigna to help them identify patients in need of these services and are aligned to a team of Cigna case managers to ensure a high degree of collaboration between the physician groups and Cigna, which will ultimately provide a better experience for the individual. Care coordinators can also help patients schedule appointments, provide health education and refer patients to the Cigna health management and wellness programs that may be available to them through their employer’s benefit plan.
Cigna will compensate physicians in the medical groups for the medical and care coordination services they provide. Additionally, physicians may be rewarded through a “pay for value” structure for meeting or exceeding targets for improving quality and lowering medical costs.
About Physician Health Partners, Primary Physician Partners and South Metro Primary Care
PHP is owned and operated by primary care physicians, including physicians in Primary Physician Partners (PPP) and South Metro Primary Care (SMPC), and was founded in 1996 as a management services organization. PHP collaborates with more than 300 primary care providers in the Denver metro area and manages two adult and one pediatric independent practice associations (IPA) that are involved in several ACO initiatives. Additionally, PHP manages Colorado Community Health Alliance, the regional care collaborative organization for Colorado Medicaid region 6. PPP is a primary care IPA comprised of family practice, internal medicine and geriatric physicians located throughout the metro Denver area with concentrations in the north and western areas. This IPA, in existence since 1996, was originally formed from Northern Health Partners and Superior Health Systems. SMPC is a primary care IPA comprised of family practice and internal medicine physicians located mainly in the southwest and east Denver metro areas. SMPC has been in existence since August 2007 and in 2012 merged with another IPA, KEY 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.