- Avoidable emergency room visits continue downward trend, seven percent better than market
- Following evidence-based medicine continues to improve, six percentage points better than market
- Medical cost trend is more than two percentage points better than market
- Diabetes is better controlled, will improve long-term health and lower medical costs
BLOOMFIELD, Conn.--(BUSINESS WIRE)-- First-year results from CIGNA's (NYSE:CI) collaborative accountable care initiative with Medical Clinic of North Texas (MCNT) indicate that these types of programs continue to show progress toward achieving the “triple aim” of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Collaborative accountable care is CIGNA's approach to accountable care organizations, or ACOs.
Since the program began, MCNT has received the highest level of recognition from the National Committee for Quality Assurance (NCQA) for meeting national quality standards for physician group medical homes. A key indicator of medical quality is how well doctors follow evidence-based medical guidelines. MCNT continues to improve its adherence to evidence-based medicine and its physicians outperformed the market by six percentage points.
CIGNA helps by sharing patient-specific data that identifies individuals who could benefit most from additional outreach and follow-up care. The care coordinator, who is fundamental to the program’s success, is a nurse on MCNT’s staff who uses the CIGNA data and reaches out to these patients.
“We’re able to share information with MCNT about potential gaps in care, such as which patients might be overdue for a mammogram or colonoscopy, or which patients with diabetes are missing important blood tests or didn’t refill a prescription,” said Dr. Mark Netoskie, senior medical director for CIGNA in Texas. “Using this information, MCNT’s care coordinator can reach out to these patients to ensure they get the care they need, which results in higher compliance with evidence-based medicine guidelines and a healthier population.”
During the program’s first year, MCNT’s enhanced care coordination improved control of A1c blood sugar levels in diabetes patients by nearly three percent. Management of cholesterol and blood pressure levels also improved for these patients. Helping people with diabetes control their disease and manage their overall health can have significant long-term benefits, including longer, more productive lives and lower medical costs. (Read MCNT patient case study.)
As part of the program, MCNT also improved patient access to care by expanding office hours, contributing to more primary care office visits.
“By making access to care more convenient through expanded office hours, and by making visits available within 72 hours for patients discharged from the hospital, we’re able to ensure that patients receive the appropriate type of care in the right setting,” said Karen Kennedy, MCNT chief executive officer. “This improves the patient’s experience while reducing total medical costs.”
Improved access to care, targeted outreach to potentially at-risk patients being discharged from the hospital, and enhanced care coordination all contributed to MCNT outperforming the market by seven percent for avoidable emergency room visits, while its hospital readmission rate declined two percentage points.
In addition to delivering more primary care and the right kind of care in the right setting, MCNT also decreased the use of costly services, such as unnecessary MRI, CT and PET scans. These factors all contributed to MCNT achieving a medical cost trend that was more than two percentage points lower than the market.
CIGNA clinical programs are available to MCNT as an extension of its own practice. Using the patient-specific data that CIGNA provides, the care coordinator can refer patients into CIGNA's disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as tobacco cessation, weight management and stress management.
“Having CIGNA's clinical programs as a resource presents a huge opportunity for us to help our patients manage their chronic conditions and improve their health,” Kennedy says. “And receiving patient-specific data from CIGNA helps us provide more coordinated, comprehensive care, which is key to achieving the triple aim of improved health outcomes, lower costs and a better patient experience.”
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 the physician practice. CIGNA is now engaged in 14 patient-centered initiatives in 13 states, encompassing more than 100,000 CIGNA customers and 1,800 physicians, including multi-payer pilots and CIGNA-only collaborative accountable care initiatives. The company plans to increase the number of initiatives significantly in 2011 and 2012. CIGNA has been a member of the Patient-Centered Primary Care Collaborative since October 2007.
CIGNA (NYSE: CI) is a global health service and financial company dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation's operating subsidiaries in the United States provide an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance. CIGNA maintains sales capability in 30 countries and jurisdictions and has approximately 66 million customer relationships throughout the world. All products and services are provided exclusively by such operating subsidiaries and not by CIGNA Corporation. Such operating subsidiaries include Life Insurance Company of North America, CIGNA Life Insurance Company of New York, and Connecticut General Life Insurance Company. To learn more about CIGNA, visit www.cigna.com. To sign up for email alerts or an RSS feed of company news, log on to http://newsroom.cigna.com/rss. Also, follow us on Twitter at @cigna, visit CIGNA’s YouTube channel at http://www.youtube.com/cigna and listen to CIGNA's podcast series with healthy tips and information at http://www.cigna.com/podcasts or by searching "CIGNA" in iTunes.
Mark Slitt, 860-226-2092
KEYWORDS: United States North America Connecticut Texas
INDUSTRY KEYWORDS: Health Hospitals Pharmaceutical Professional Services Insurance Diabetes General Health Managed Care