Ohio

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Cincinnati Aligning Forces for Quality (Cincinnati AF4Q) is led by the Health Collaborative. Established in 1992, the Health Collaborative is a diverse coalition of health care stakeholders representing the hospital, physician, employer, insurer, government, education and consumer sectors. Its mission is to stimulate significant and measurable improvement in the health status of the people in Greater Cincinnati through collaborative leadership. 

Ohio signed a Memorandum of Understanding with CMS on 12/11/2012. In collaboration with CMS, Ohio will extend coordinated care to its dual eligible population through an Integrated Care Delivery System (ICDS).

The Enhanced Personal Health Care Program empowers primary care physicians (PCPs) to engage in comprehensive primary care functions that move toward a coordinated, evidence-based care model that has the greatest impact on achieving the triple aim of improved quality, patient experience and affordability.  

This Program:  

Cigna and University Hospitals Accountable Care Organization (UHACO) have launched a collaborative accountable care initiative to enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience for Cigna customers.

Under the program, Central Ohio Primary Care Physicians (one of the largest physician-owned primary care medical groups in the United States, serving Columbus and other central Ohio communities), monitors and coordinates all aspects of an individual's medical care. Patients 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 in the medical group will also have access to the benefits of the program.

Under the program,  Mount Carmel Health Partners (a comprehensive integrated delivery system in Columbus), monitors and coordinates all aspects of an individual's medical care. Patients 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 in the medical group will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists.

Under the program, Cleveland Clinic (a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education), monitors and coordinates all aspects of an individual's medical care. Patients 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 in the medical group will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists.