BLOOMFIELD, Conn. & NEW BRUNSWICK, N.J., December 20, 2011 – Cigna (NYSE:CI) and Partners In Care (“PIC”), an independent physicians organization based in Central New Jersey, have launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the “triple aim” of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Collaborative accountable care is Cigna’s approach to accountable care organizations, or ACOs.
An ACO is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs. Cigna’s program with PIC is the first patient-centered accountable care program in Central and Northern New Jersey involving an independent physicians organization and a health plan.
The program is focused on approximately 14,000 individuals covered by a Cigna health plan who receive care from among 360 doctors at more than 160 participating physician practices. Individuals who are enrolled in a Cigna health plan and later choose to seek care from one of the participating practices will also have access to the benefits of the program.
“Patients with chronic conditions, such as diabetes or hypertension, see many different specialists and health care professionals with little to no coordination among them. It is unnecessary, disorganized and dangerous,” said Steven Goldberg, M.D., chairman, PIC. “Monitoring these patients and ensuring their care givers are talking to one another – with one patient-selected personal physician in the leadership role – will undoubtedly lead to safer, more consistent, and more effective medical care.”
“Cigna and Partners In Care have shared values, and the commitment to patient-centered care is evident in every aspect of this program,” said Kevin O’Brien, president & CEO, PIC. “As we work together to help patients remain healthy, the overall costs are less – it’s a win for everyone.”
The participating physician practices will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physician and will not need to do anything to receive the benefits of the program. There also 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 clinicians and registered nurses, employed by Partners In Care, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators will enhance care by using patient-specific data that Cigna provides to 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 will work with the patient’s physician to 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 will also help an individual’s medical home provide health education and refer individuals to Cigna’s clinical 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.
“The current health care system is focused on treating illness and rewards physicians for volume rather than value; it’s not designed to drive long-term health improvement and lower costs,” said Dr. Ron Menzin, Cigna’s medical director for New Jersey. “If our goal is a healthier population and lower medical costs, we need to create a patient-centered health care system that emphasizes prevention and primary care and that rewards physicians for quality of care and improved health outcomes.”
Cigna will pay physicians as usual for the medical services they provide. Partners In Care will also pay the physicians for the care coordination services they provide on the patient’s behalf. Additionally, physicians may be rewarded through a “pay for performance” structure if they meet targets for improving quality and lowering medical costs.
“Employers bear a large portion of the nation’s health care costs, so it’s important to them to find a model of health care that can lower these costs through improved employee health,” said Laurel Pickering, president & CEO of the Northeast Business Group on Health (NEBGH). “This patient-centered collaboration between Cigna and Partners In Care is an excellent example of how health plans and physicians can work together to achieve a healthy, productive work force and create a health care system that works for everyone.”
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 the physician practice. With the addition of Partners In Care, Cigna is now engaged in 17 patient-centered initiatives in 15 states, encompassing more than 170,000 Cigna customers and more than 1,800 primary care physicians, including multi-payer pilots and Cigna-only collaborative accountable care initiatives. The company plans to continue increasing the number of initiatives significantly in 2012. Cigna has been a member of the Patient-Centered Primary Care Collaborative since October 2007.
Cigna (NYSE: CI) is a global health service and financial company dedicated to helping people improve their health, well-being and sense of security. Cigna Corporation’s operating subsidiaries in the United States provide an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance.
About Partners In Care
Partners In Care, Corp. (PIC) is a privately held, physician owned, for-profit provider of healthcare and management services. With a broad network of independent community physicians throughout New Jersey.