BLOOMFIELD, Conn. & CONCORD, N.H., May 29, 2012 - Cigna and the Granite Healthcare Network (GHN), a partnership among five independent charitable health care organizations in New Hampshire, have launched a collaborative accountable care (ACO) 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 accomplishing the same population health goals as accountable care organizations.
The Granite Healthcare Network (Concord Hospital, Elliot Health System, LRGHealthcare, Southern New Hampshire Health System and Wentworth-Douglass Hospital) and Cigna have launched an accountable care program to improve health and lower medical costs. (Photo: Cigna)
The Granite Healthcare Network comprises Concord Hospital, Elliot Health System, LRGHealthcare, Southern New Hampshire Health System and Wentworth-Douglass Hospital. Each member is an independent, integrated health care delivery system consisting of primary care doctors, specialists and hospitals.
Cigna's patient-centered collaboration with GHN is believed to be the largest accountable care program in New Hampshire that links doctors, hospitals and a single health plan.
The program will benefit more than 23,000 individuals covered by a Cigna health plan who receive care from among more than 900 GHN-participating health care professionals. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a GHN-participating physician will also have access to the benefits of the program.
“Cigna has been a leader in accountable care, both here in New Hampshire and throughout the country, which is why we chose Cigna as the health plan for this initiative,” said Greg Baxter, M.D., chief medical officer for the Granite Healthcare Network. “We believe that this arrangement with Cigna offers the best opportunity for us to improve health care quality, lower medical costs and help our patients lead healthier and more productive lives.”
Each of the GHN-participating organizations 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 registered nurses, employed by each of the five GHN health care organizations, who serve as clinical care coordinators and are integrated into the care delivery team to help patients with chronic conditions or other health challenges navigate their health care system.
The care coordinators will enhance care by using patient-specific data provided by Cigna 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 contact these individuals to help them 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 also will help patients schedule appointments, provide health education and refer patients 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. This initiative is unique in using data and analytics at the health system level to focus health care professionals more fully on engaging patients to improve the coordination of their care as well as develop best practice clinical initiatives across the GHN member health systems.
“The five Granite Healthcare Network organizations share our vision for a patient-centered health care system that emphasizes prevention and primary care and rewards physicians for care quality and health outcomes,” said Donald Curry, president for Cigna in New England. “We believe that a system that’s focused on value rather than volume of care offers the best path to improved health and lower medical costs, which is good for individuals, families, employers and doctors.”
Cigna will compensate GHN for the medical and care coordination services its participating organizations provide. Additionally, the organizations may be rewarded through a “pay for performance” structure if they meet their targets for improving quality and lowering medical costs. Employers who sponsor health plans will benefit from lower health care costs or health care costs that increase at lower rates.
“The Granite Healthcare Network and Cigna are to be commended for this initiative that will benefit the citizens of New Hampshire,” said Paul Grundy, M.D., MPH, global director of healthcare transformation at IBM and president of the Patient-Centered Primary Care Collaborative. “This patient-centered collaboration is an excellent example of how health plans can work with physicians and hospitals to help create a health care system that works for everyone. Putting patients and their families at the center of care gives patients much better access to care, empowers them to communicate more effectively with their health care professional, gives physicians tools to better integrate and coordinate care, and helps improve the healing relationship between patients and their doctors.”
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 medical organizations. Cigna is now engaged in 32 patient-centered initiatives in 17 states, including six multi-payer medical home pilots and 26 Cigna-only collaborative accountable care initiatives. The collaborative accountable care initiatives encompass more than 270,000 Cigna customers and more than 4,000 physicians.
In New England, Cigna has collaborative accountable care arrangements in Connecticut with ProHealth Physicians; in Maine with Eastern Maine Healthcare Systems, Kennebec Region Health Alliance, Penobscot Community Healthcare, plus two other physician practices that have not yet been announced; and in New Hampshire with Dartmouth-Hitchcock Clinic.
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 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 and vision care benefits, and other related products including group disability, life, and accident coverage. Cigna has sales capability in 30 countries and jurisdictions, with approximately 70 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 Granite Healthcare Network (GHN)
GHN is a network of charitable organizations that are leading the transformation of healthcare delivery in New Hampshire by leveraging their collective intellectual and clinical resources to improve quality, cost-effectiveness and access beyond what any one of them could achieve individually. The member hospitals — Concord Hospital, Elliot Health System, LRGHealthcare, Southern New Hampshire Health System, and Wentworth-Douglass Hospital — have joined forces to implement innovative initiatives focused on the triple aim of providing better health for communities and better care for patients at an affordable cost. www.granitehealth.org
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