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TMCNet:  St. Joseph Health System and Cigna Start Collaborative Care Program to Improve Health and Lower Costs

[July 09, 2014]

St. Joseph Health System and Cigna Start Collaborative Care Program to Improve Health and Lower Costs

BRYAN, Texas --(Business Wire)--

Cigna (NYSE: CI) and St. Joseph Health System 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 became effective July 1 and is Cigna's first collaborative care initiative serving the Brazos Valley. Cigna currently has eleven collaborative care arrangements throughout Texas and 100 of them nationwide.

Cigna Collaborative Care is the company's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit approximately 4,000 individuals covered by a Cigna health plan who receive care from approximately 265 primary care doctors and specialists with St. Joseph in the Brazos Valley.

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.

"St. Joseph Health System has been at the forefront of developing programs to help keep our patients well and improve the overall health of our community. Our new partnership with Cigna is just one more example of this. In partnership with our physicians and advanced practitioners conveniently located throughout the Brazos Valley, the care coordination model allows us to work even more closely with our patients, helping them achieve their individual health and wellness goals," said Dan Dawson, M.D., St. Joseph Health System Chief Medical Officer for clinical itegration.


"A system that's focused on value rather than volume ultimately leads to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors," said Mike Koehler, president and general manager for Cigna in South Texas. "These goals can only be reached by working in collaboration with health care professionals, and St. Joseph shares this same vision for the future of our health care system. We are pleased to be working with St. Joseph and to expand our collaborative care program to the Brazos Valley."

Under the program, St. Joseph Health System doctors 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 doctor with St. Joseph Health System 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 are the registered nurse clinical care coordinators, employed by St. Joseph Health System, who will help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are 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 care coordinators will enhance care by using 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. The care coordinators are part 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.

Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support programs that may be available as part of their health plan, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs for quitting smoking or managing weight.

Cigna will compensate St. Joseph Health System for the medical and care coordination services doctors provide. Additionally, St. Joseph may be rewarded through a "pay for value" structure for meeting 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 100 Cigna Collaborative Care arrangements with large physician groups that span 27 states, reach more than one million commercial customers and encompass more than 39,000 doctors, including more than 19,000 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® care model for Medicare customers. Today, more than 1.3 million Cigna and Cigna-HealthSpring customers benefit from 265 engaged physician relationships across 31 states, with more than 66,000 doctors participating, including more than 25,000 primary care physicians and more than 41,000 specialists.

About St. Joseph Health System

Established in 1936, St. Joseph Health System is a faith-based, not-for-profit health system that is owned and operated by the Sisters of St. Francis of Sylvania, Ohio. With five hospitals, two long-term care facilities and numerous family medicine and specialty clinics, St. Joseph continues to carry out its original mission to provide excellent healthcare.

About Cigna

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 more than 80 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook (News - Alert) or Twitter, visit www.cigna.com.


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