Global health insurer Cigna Corporation (NYSE:CI) is collaborating with a Washington state health system on several initiatives geared toward improving health and lowering costs, some of which include physician follow-ups on patients transitioning from hospital to home.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations (ACOs). Its collaboration with EvergreenHealth Partners (EHP) launched July 1 and is the insurer’s third collaborative care agreement in the state of Washington.
At the heart of EHP’s clinically integrated network of more than 500 physicians and health care professionals is EvergreenHealth, a 318-bed acute care hospital and health system located in Kirkland, WA.
In places where it is introduced, Cigna Collaborative Care strives to implement programs geared toward closing gaps in care, such as health screenings, prescription refills, reducing unnecessary use of hospital emergency rooms and improving follow-up care for people transitioning from the hospital to home.
“This collaboration presents an excellent opportunity to help create a better health care delivery system,” stated John Sobeck, Cigna’s senior medical director for Washington. “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.”
The collaboration between Cigna and EHP will benefit nearly 5,700 individuals covered by a Cigna health plan who receive care from EHP primary care doctors and specialists, the company stated in a release.
Under the program, EHP will monitor and coordinate all aspects of an individual’s medical care. Those enrolled in a Cigna health plan and later choose to seek care from an EHP health care professional will also have access to the benefits of the program.
There are no changes in any plan requirements regarding referrals to specialists, Cigna assures, however, patients most likely to see the immediate benefits of the program are those who need assistance managing chronic conditions, such as diabetes, heart disease and obesity.
Care coordinators will use 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.
Cigna will compensate EHP for the medical and care coordination services it provides, the company stated. Additionally, the medical group may also be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.
“We are acutely focused on advancing the health of the community we serve through our dedication to high-quality, safe, compassionate and cost-effective health care,” stated EvergreenHealth CEO Bob Malte. “By working collaboratively with Cigna and focusing on improved care coordination and preventative care, we hope to drive even higher quality of care, better health and an enhanced patient experience.”
Cigna currently has 100 of its Collaborative Care arrangements that span 27 states, encompassing more than 39,000 doctors, including more than 19,000 primary care physicians and more than 20,000 specialists.
Written by Jason Oliva