Cigna (NYSE: CI) and North Texas CIN, Inc. (TXCIN) have launched a collaborative care initiative to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. The program, which became effective January 1, is Cigna’s sixth collaborative care initiative in North Texas.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 12,000 individuals covered by a Cigna health plan who receive care from more than 230 primary care doctors and specialists at TXCIN.
In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while holding the line on medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reducing unnecessary use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.
“Our collaboration with Cigna is a logical step and a great fit for us,” said John Moore, M.D., president of TXCIN. “We focus every day on improving the health care delivery system by rewarding physicians for leading patients to healthier outcomes and providing a better patient experience.”
“This collaboration presents an excellent opportunity to help transform the health care delivery system,” said Dr. Rick Watson, Cigna’s senior medical director for North Texas. “When we reward doctors for results and focus on prevention, wellness, health improvement and care coordination, we can create a system that works for everyone who uses, pays for or delivers health care.”
Under the program, TXCIN will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current TXCIN 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 TXCIN doctor will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Individuals 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 benefits are the registered nurse clinical care coordinators, employed by TXCIN, who will help people 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, 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 individuals being discharged from the hospital who might be at risk for readmission, as well as those 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 individuals 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 individuals 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 TXCIN for the medical and care coordination services it provides. Additionally, the physician group may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 114 Cigna Collaborative Care arrangements with large physician groups that span 28 states, reach more than 1.2 million commercial customers and encompass more than 48,000 doctors, including more than 23,000 primary care physicians and more than 25,000 specialists.
Cigna Collaborative Care is one component of the company’s approach to physician engagement for health improvement, which also includes the innovative Cigna-HealthSpring® care model for Medicare customers. Today, more than 1.5 million Cigna and Cigna-HealthSpring customers benefit from nearly 280 engaged physician relationships across 31 states, with more than 79,000 doctors participating, including more than 33,000 primary care physicians and more than 46,000 specialists.
About Texas Clinically Integrated Network
Texas Clinically Integrated Network, Inc. is a non-profit clinically integrated network of primary care and specialty care providers in Texas who have aligned on a single collaborative platform to optimize crossspecialty standards of care, monitor outcome performance in real-time and collaborate with payors to optimize delivery of care for their specific populations.
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 85 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.