Cigna and HealthTexas Provider Network (HTPN), a large physician group in the Dallas/Ft. Worth Metroplex that is affiliated with Baylor Health Care System, have expanded their collaborative accountable care initiative to include additional HTPN doctors and clinic locations.
HTPN monitors and coordinates all aspects of an individual’s medical care. Critical to the program’s benefits are registered nurses, employed by HTPN, 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 physicians for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a “pay for performance” structure if it meets targets for improving quality and lowering medical costs.
