WINSTON-SALEM, N.C. & BLOOMFIELD, Conn.--(Novant Health, an integrated system of hospitals and physician practices, 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 is effective April 1.)--Cigna (NYSE: CI) and
“A patient-centered system that’s focused on prevention and wellness, combined with the right incentives for physicians, will ultimately result in a healthier population and lower medical costs. That’s good for individuals, families, employers and doctors.”
Collaborative accountable care (CAC) is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 60,000 individuals covered by a Cigna health plan who receive care from a Novant Health physician in communities throughout the Carolinas, making it Cigna's largest CAC nationally. The program with Novant Health is Cigna's fourth such collaboration in the Carolinas.
“At Novant Health, what’s most important is improving the health of our communities, one person at a time,” said Carl Armato, chief executive officer of Novant Health. “We are committed to quality care that delivers superior results for our patients. We are dedicated to making their health care experience remarkable so that patients may focus on what really matters: getting better and staying healthy.
“Coupled with the high number of Novant Medical Group practices that are certified as patient-centered medical homes by the National Committee for Quality Assurance (NCQA), the Cigna CAC is a complementary pairing to keep our focus on patient care and coordination,” stated Armato.
“We’re aiming to fundamentally change the health care delivery system by rewarding physicians for results,” said Edward Hunsinger, M.D., Cigna’s senior medical director for the Carolinas. “A patient-centered system that’s focused on prevention and wellness, combined with the right incentives for physicians, will ultimately result in a healthier population and lower medical costs. That’s good for individuals, families, employers and doctors.”
Under the program, Novant Health monitors and coordinates all aspects of an individual’s medical care. Patients continue to go to their current physician and automatically receive the benefits of the program. In addition, many patients using Novant Medical Group physicians will be managed using the EPIC electronic medical record system installed in practices, as well as have access to My Chart, an electronic patient access tool that enables patients to communicate with their care team and review medical records online.
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 or heart disease.
Benefits to Patients
Critical to the program’s benefits are registered nurses, employed by Novant Health, 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 medical group 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, 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 Novant Health for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a “pay for value” structure if it meets 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 is now engaged in nearly 60 collaborative accountable care initiatives in 24 states, encompassing more than 650,000 Cigna customers and more than 23,000 doctors, including more than 11,000 primary care physicians and more than 11,500 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.
About Novant Health
Novant Health is a not-for-profit integrated group of 13 hospitals and a medical group consisting of 1,124 physicians in 345 clinic locations, caring for patients and communities in North Carolina, Virginia, South Carolina and Georgia. Hospitals include the following: Presbyterian Hospital, Presbyterian Orthopaedic Hospital, Presbyterian Hospital Matthews and Presbyterian Hospital Huntersville in the Charlotte, NC area; Forsyth Medical Center and Medical Park Hospital in Winston-Salem, NC; Kernersville Medical Center, Kernersville, NC; Thomasville Medical Center, Thomasville, NC; Brunswick Novant Medical Center, Bolivia, NC; Rowan Regional Medical Center, Salisbury, NC; Franklin Regional Medical Center, Louisburg, NC; Upstate Carolina Medical Center, Gaffney, SC; and Prince William Hospital, Manassas, VA. Other Novant facilities and programs include outpatient surgery centers, medical plazas, rehabilitation programs, diagnostic imaging centers and community health outreach programs. Novant Health is ranked 21st nationally among the 2012 Top 100 Integrated Healthcare Networks, according to an analysis by the IMS health informatics company.
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 78 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.