Cigna continues to expand its collaborative accountable care (CAC) program through 10 new initiatives with physician groups in nine states, including the company’s first CACs in Florida, Indiana, Louisiana and South Carolina. With the addition of these initiatives, Cigna now has 52 collaborative accountable care programs in 22 states covering nearly 510,000 customers, and remains on track to reach its goal of 100 initiatives for one million customers by the end of 2014. Cigna launched its first collaborative accountable care program in 2008. These programs focus on expanding patient access to health care, improving care coordination, and achieving the “ triple aim” of improved health outcomes (quality), affordability and patient satisfaction. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs, with a strong focus on high-risk individuals, including people with chronic health conditions such as diabetes or heart disease. In places where it’s been introduced, collaborative accountable 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 prescriptions refills, and they’re reducing unnecessary use of hospital emergency rooms, increasing the number preventive health visits and improving follow-up care for people transitioning from the hospital to home. For example, in 2011, Medical Clinic of North Texas (MCNT) improved total medical cost trend by 4.4 percent while maintaining quality (as measured by following evidence-based medical guidelines) at four percent better than the North Texas market. During the same period, EMHS (Eastern Maine Healthcare Systems) maintained quality at five percent better than its market. Also in 2011, Holston Medical Group had an overall emergency room visit rate that was 12 percent lower than its Eastern Tennessee market, while avoidable emergency room visits for Cigna Medical Group were 24 percent lower than the Phoenix market.