Cigna (CI) has launched collaborative care initiatives with three North Texas medical groups. The new arrangements with Catalyst Health Network, Dallas Methodist Physicians Network (DMPN) and Genesis Accountable Physician Network (GAPN) aim to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. With the launch of these three programs, which became effective April 1, Cigna now has nine collaborative care initiatives in the Dallas/Fort Worth Metroplex.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. These three new programs will benefit more than 22,000 individuals covered by a Cigna health plan who receive care from more than 260 primary care doctors at the three groups.
In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reinforcing the appropriate 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.
“We’re looking forward to this collaboration with Cigna, which is an excellent opportunity for our independent physicians to continue bringing real value to our communities by delivering superior quality of care while holding the line on cost,” said Dr. Christopher Crow, president of Catalyst Health Network.
“Improving the lives of our patients through quality care is at the heart of our mission, which is why this collaboration with Cigna is a great fit for us,” said Michael S. Marshall, M.D., chair of the DMPN board of directors. “Care coordinators will play a pivotal role because better coordinated care is fundamental to better health and lower costs.”
“We believe that health care relies on solid relationships, and this new collaboration builds relationships between our independent physician members, patients, and Cigna,” said Dr. Jim Walton, president and CEO of Genesis Physicians Group. “Care coordination, which is central to this collaboration, supports our members as they help patients manage chronic conditions and live healthier lives.”
“Through these types of collaboration we have the opportunity to help transform the health care delivery system,” said Dr. Frederick 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, the medical groups will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physicians and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from these 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 benefits are the registered nurse clinical care coordinators, employed by the medical groups, who will 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 groups 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 individuals 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 teams that will help people 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 people 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 the medical groups for the medical and care coordination services they provide. Additionally, the physician groups may be rewarded through a “pay for value” structure if they meet 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 122 Cigna Collaborative Care arrangements with large physician groups that span 29 states, reach more than 1.3 million commercial customers and encompass more than 50,000 doctors, including more than 24,000 primary care physicians and more than 27,000 specialists.
Cigna Corporation (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 more than 86 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
About Catalyst Health Network
Catalyst Health Network is a clinically integrated network of physicians designed to provide coordinated, high-quality care to patients. Catalyst provides independent physicians a dynamic population health platform that is critical to reach the Triple Aim in healthcare – higher quality, improved cost and an enhanced patient experience. Physicians are able to remain independent while enjoying the services and structure needed to be successful in the new, value-based world of healthcare. Catalyst received certification by the Texas Medical Board as a nonprofit health corporation. The network is comprised solely of physician members and managed by StratiFi Health, a physician services organization. For more information, visit www.catalysthealthnetwork.com or follow @CatalystHN on Twitter.
About Dallas Methodist Physicians Network
Dallas Methodist Physicians Network is a non-profit healthcare organization certified by the Texas Medical Board which has been in the Dallas market since 1986. The network is comprised of independently practicing primary care physicians and medical specialist physicians with offices in Arlington, Dallas, DeSoto, Duncanville, Grand Prairie, Mansfield, McKinney, Midlothian, Richardson, and Waxahachie. The network’s hallmark is its emphasis on the use of nationally recognized evidence based quality metrics, and excellent in office practice standards.
About Genesis Physicians Group
Based in Dallas, Texas, Genesis Physicians Group is the largest independent physicians association in North Texas with 1,400 primary and specialty care physician members. Genesis provides services to support private practices in the business of medicine. Its clinically integrated subsidiary, Genesis Accountable Physician Network (GAPN), operates with nearly 400 physicians. GAPN offers members value-based contracting, care coordination services, and performance improvement initiatives to enhance health outcomes. Visit www.genesisdocs.org and www.genesisaco.com for more information.
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