Cigna (NYSE:CI) and Summit Medical Group, New Jersey's largest physician-owned multispecialty practice, today announced a collaborative accountable care program to achieve the “triple aim” of improved health outcomes (quality), lower total medical costs and increased patient satisfaction.
The joint program, which took effect December 1, benefits approximately 10,000 individuals covered by a Cigna health plan who receive care from more than 300 Summit Medical Group providers. Summit Medical Group treats patients at its 42-acre main campus in Berkeley Heights as well as at 20 area satellites in Berkeley Heights, Bayonne, Morristown, Millburn, Short Hills, Springfield, New Providence, Warren, Westfield and West Orange.
“Summit Medical Group has long embraced the coordinated care model as the best way to deliver quality care and patient satisfaction,” said Jeffrey Le Benger, chairman and chief executive officer. “Our emphasis on preventive care and collaboration makes Cigna a natural partner for us as we work together to improve the patient experience and enhance the health care delivery system.”
Through its electronic health record, Summit Medical Group doctors monitor and coordinate all aspects of an individual’s medical care. In this arrangement with Cigna, patients will continue to go to their current SMG physician and automatically receive the benefits of the program. There also are no changes in any plan requirements regarding referrals to specialists. While all patients will benefit from this initiative, 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.
“The only sustainable way to control rising medical costs is to improve health,” said Charlie Catalano, president and general manager for Cigna in New Jersey. “Helping people reduce their health risks, preventing health problems before they happen, stopping disease before it progresses and helping to ensure the right care, at the right time, in the right place are all at the heart of our collaboration with Summit Medical Group.”
Cigna's collaborative accountable care programs work to accomplish the same population health goals as accountable care organizations, or ACOs:
- Improved access to care
- Increased emphasis on preventive care
- Greater care coordination and patient engagement
- Better management of chronic illness (or chronic diseases)
- Lower hospital readmissions
- Reduced health care costs through alignment of payment with improved outcomes, quality and value.
Critical to the benefits of the Cigna-Summit program are registered nurses, employed by Summit Medical Group, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. Using patient-specific data from Cigna and from Summit Medical Group’s electronic health record, care coordinators identify patients 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 a medication-related issue. Part of Summit Medical Group's physician-led team, care coordinators help patients get the follow-up care or screenings they need. The care coordinators are aligned to a team of Cigna case managers to ensure a high degree of collaboration between Summit Medical Group and Cigna that ultimately results in a better experience for the individual.