Connecticut State Medical Society-IPA, Inc. and Cigna Launch Statewide Collaborative Care Program that Reaches Small and Mid-Size Medical Practices
Cigna (NYSE:CI) and the Connecticut State Medical Society-IPA, Inc. (CSMS-IPA), an independent practice association, 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 October 1, is Cigna’s ninth collaborative care arrangement in Connecticut and its first anywhere with a state medical society IPA. It is also CSMS-IPA’s first commercial arrangement of this type.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. While Cigna has more than 100 of these arrangements nationwide with large physician practices, this arrangement with CSMS-IPA is focused on reaching Cigna customers who get their medical care from small and mid-size practices, and is consistent with the company’s strategy, announced earlier this year, to broaden the scope of Cigna Collaborative Care.
The program will benefit more than 50,000 individuals covered by a Cigna health plan who receive care from more than 530 primary care doctors and specialists in approximately 285 practices that are members of the CSMS-IPA, making it one of Cigna’s largest collaborative care arrangements nationally.
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.
“This collaboration with Cigna is an exciting opportunity to support and reward our physician membership for their efforts and successes in delivering high quality, patient-centered care,” said Neysa Guerino, executive director of CSMS-IPA.
“This is a tremendous opportunity to bring improved health, affordability and patient experience to Cigna customers who get their medical care from doctors in smaller practices,” said Dr. Robert Hockmuth, Cigna’s senior medical director for Connecticut. “When we collaborate with physicians and provide incentives that reward them for results, and when there’s a strong focus on prevention, wellness and care coordination, we can expect to have a healthier population and lower medical costs.”
Under the program, doctors who are part of the CSMS-IPA will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current 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 participating CSMS-IPA doctor 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 is the clinical care coordination, which will help patients with chronic conditions or other health challenges navigate the health care system. The care coordination team is 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 CSMS-IPA will enhance care by using patient-specific data from Cigna to help physician practices 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 coordination is an integral function of the physician-led care team that will help patients get the follow-up care or screenings they need, identify potential complications related to medications and help prevent chronic conditions from worsening.
The care coordination team can also help patients 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 CSMS-IPA and its physician members for the medical and care coordination services they provide. Additionally, CSMS-IPA 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 105 Cigna Collaborative Care arrangements with large physician groups that span 27 states, reach more than 1.1 million commercial customers and encompass more than 41,000 doctors, including more than 20,000 primary care physicians and more than 20,000 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(R) care model for Medicare customers. Today, more than 1.4 million Cigna and Cigna-HealthSpring customers benefit from 270 engaged physician relationships across 31 states, with more than 68,000 doctors participating, including more than 26,000 primary care physicians and more than 41,000 specialists.
About CSMS-IPA, Inc.
The Connecticut State Medical Society – IPA (CSMS-IPA) is the largest and only statewide IPA in Connecticut and one of the largest in the nation. The CSMS-IPA is comprised of approximately 7,000 physician members throughout Connecticut and is governed by a 27-member Board of Directors. The CSMS-IPA’s mission statement is “to promote high-quality, cost-effective medical care which is physician driven, financially sustainable and valued by healthcare stakeholders.” More information can be found on www.csms-ipa.com.
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(R), including links to follow us on Facebook or Twitter, visit www.cigna.com.
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