Cigna and New West Physicians, P.C., a large physician group in Denver, launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the triple aim of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Critical to the program's benefits are registered nurses, employed by New West Physicians, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system.
The care coordinators enhance care by using patient-specific data provided by Cigna to 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 contact these individuals to help them get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening. The care coordinators also help patients schedule appointments, provide health education and refer patients to Cigna's clinical programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.
Cigna will compensate New West Physicians P.C. for the medical and care coordination services they provide. Additionally, they will be rewarded through a “pay for value” structure for meeting targets for improving quality and lowering medical costs.
