Benefits

CIGNA, New York Physician Group Launch Accountable Care Initiative

By Joanne Wojcik

Jan. 11, 2012

CIGNA Corp. is launching a collaborative medical home initiative with the Weill Cornell Physician Organization in New York that will operate much like accountable care organizations outlined in the federal health care reform law.

Accountable care organizations, introduced as part of the Patient Protection and Affordable Care Act of 2010, are networks of health care providers that are held accountable for the overall care of health plan members in exchange for additional compensation to improve outcomes and reduce medical costs. CIGNA’s collaboration with Weill Cornell is the first such accountable care initiative in New York involving a health plan and a physician organization.

The Bloomfield, Connecticut-based insurer introduced a similar initiative last month with Partners in Care, an independent physician organization based in New Brunswick, New Jersey.

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, CIGNA said Jan. 11 in a statement.

Under the program, registered nurses employed by 71 Weill Cornell primary care physicians will serve as clinical care coordinators, using patient-specific data provided by CIGNA to identify and reach out to patients discharged from the hospital who might be at risk for readmission, patients who may be overdue for important health screenings or those who may have skipped a prescription refill, the statement said.

The care coordinators also will help patients schedule appointments, provide health education, and refer patients to CIGNA’s disease and lifestyle management programs.

“We believe that initiatives such as this will help transform the way medicine is practiced in the United States from a system that’s focused mainly on treating illness and rewarding physicians for volume to one that’s patient-centered and emphasizes prevention and primary care,” CIGNA Chief Medical Officer Dr. Alan Muney said in the statement.

“We’ve already seen very promising early results in locations where we’ve implemented this type of program, and we believe these initiatives ultimately will lead to a healthier population and lower medical costs.

“CIGNA now operates 11 accountable care programs in 10 states, with the first one launched in New Hampshire in June 2008. The insurer also participates in six multipayer medical home initiatives across the country.

Joanne Wojcik writes for Business Insurance, a sister publication of Workforce Management. To comment, email editors@workforce.com.

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Joanne Wojcik writes for Business Insurance, a sister publication of Workforce Management.

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