Beacon Health and Cigna Form Accountable Care Program in Maine to Improve Health and Lower Costs

  • Consumers benefit from improved care coordination and greater emphasis on preventive care
  • Primary care doctors are rewarded for improving patient health and lowering medical costs
  • Program includes registered nurse care coordinators aligned with Cigna case managers

BREWER, Maine & BLOOMFIELD, Conn.--()--Cigna (NYSE: CI) and Beacon Health, a subsidiary of EMHS (Eastern Maine Healthcare Systems), 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.

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 nearly 7,000 individuals covered by a Cigna health plan who receive care from Beacon Health’s 600 primary care doctors and specialists.

“The needs of our patients have always been our top priority and this collaboration with Cigna will help ensure patients have access to quality, well-coordinated care, especially those with chronic illnesses or medically complex conditions,” said Dr. Iyad Sabbagh, senior medical director at EMHS Beacon Health. “We believe this program will also benefit our doctors and staff as we see improved health outcomes and lower medical costs.”

“Our goal is to change the U.S. health care system from one that emphasizes the amount of care delivered to one that focuses on the quality of that care,” said Dr. Robert Hockmuth, Cigna’s senior medical director for New England. “A patient-centered system that’s focused on prevention and wellness, and that rewards doctors for value rather than volume of services, is expected to result in a healthier population and lower medical costs, which is good for individuals, families, employers and doctors.”

Under the program, Beacon Health 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 EMHS Beacon Health and embedded in the primary care practices, who will serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. EMHS Beacon Health 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 Beacon Health for the medical and care coordination services it provides. Additionally, Beacon Health 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 Beacon Health

Beacon Health is a subsidiary of EMHS that is focused on reinventing how healthcare is delivered throughout Maine. Formally developed in 2012, this branch of EMHS is focused on population health management and aims to better coordinate patient care across all types of health services. In doing so, EMHS’ goal is to ensure Maine people have access to the best in healthcare, reduce costs, and help people live as healthy a life as possible.

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.

Contacts

Cigna
Michelle Vroom, 215-761-2104
michelle.vroom@cigna.com
or
Beacon Health
Lanie Abbott, 207-356-0281
lwabbott@emhs.org

Release Summary

Cigna and Beacon Health have launched an accountable care program to achieve the “triple aim” of improved health, affordability and patient experience.

Sharing

Contacts

Cigna
Michelle Vroom, 215-761-2104
michelle.vroom@cigna.com
or
Beacon Health
Lanie Abbott, 207-356-0281
lwabbott@emhs.org