Cigna collaborative care program with Day Kimball Healthcare

Program Location: 
Putnam, CT
Payer Type: 
Commercial
Partner Organizations: 
Day Kimball Healthcare
Payers: 
Cigna

Reported Outcomes

Description: 

Cigna and Day Kimbell Healthcare have a collaborative care initiative to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. Putnam-based Day Kimball Healthcare and its affiliated physicians group is an integrated medical services network serving northeast Connecticut that has participated in Cigna Collaborative Care since October 2012. 

Much of Day Kimball’s success can be attributed to the care coordinators - registered nurses employed by the medical group who help individuals navigate the health care system, help them get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening. For example, when Cigna customers are hospitalized at Day Kimball Hospital, the care coordinator visits them at their bedside for an initial transition of care discussion, and then reaches out within two business days after discharge. The care coordinator identifies individuals who could benefit from Cigna clinical programs, such as stress or weight management, or chronic condition management for diabetes, and coordinates with Cigna to enroll individuals in those programs. The care coordinator also identifies individuals who have a high health risk score and collaborates with an aligned Cigna case manager to discuss the most appropriate plan of care.

 

Payment Model: 

Cigna compensates Day Kimbell Healthcare for the medical and care coordination services it provides. Additionally, the physician group may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.

Fewer ED / Hospital Visits: 

Cigna press release (May 2015)

  • overall emergency room use is down and is trending 3.4 percent better than market
  • avoidable emergency room visits (visits for non-emergency care) are down 9 percent year over year
Cost Savings: 

Cigna press release (May 2015)

  • medical cost trend is beating the Connecticut market by 4.2 percent.
Increased Preventive Services: 

Cigna press release (May 2015)

  • improved breast cancer screening, diabetes care and cervical screening
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