Cigna and Skylands Medical Group, a primary care-based, multispecialty medical group serving Northwest New Jersey, have launched a collaborative care initiative to improve patient access to health care, enhance care coordination and achieve the goals of better health, affordability and patient experience. The program began July 1 and is Cigna's fifth collaborative care arrangement in New Jersey. The insurer has 100 such arrangements nationwide.
Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 5,000 individuals covered by a Cigna health plan who receive care from nearly 20 Skylands primary care doctors.
In places where it’s been introduced, Cigna said, the program is helping to improve the health of Cigna members while holding the line on medical costs. It focuses on closing gaps in care, such as missed health screenings or prescription refills, reducing unnecessary use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.
“Skylands Medical Group is committed to helping our patients improve their lives through the quality care we deliver every day,” said Donna McCloskey, director of Patient Centered Medical Home for Skylands. “By working collaboratively with Cigna and focusing on improved care coordination and preventive care, we hope to drive even higher quality of care, better health and an enhanced patient experience.”
“This collaboration presents an excellent opportunity to help create a better health care delivery system,” said Dr. Ronald Menzin, Cigna’s senior medical director for New Jersey. “When we reward doctors for results and focus on prevention, wellness, health improvement and care coordination, we can create a system that works for everyone who uses, pays for or delivers health care.”
Under the program, Skylands Medical Group will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current Skylands 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 Skylands doctor will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes, heart disease and obesity.
Skylands employs registered nurse clinical care coordinators who will help patients with chronic conditions to navigate the health care system. Cigna will compensate Skylands for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.
Cigna now has 100 Cigna Collaborative Care arrangements with large physician groups that span 27 states, reach more than one million commercial customers and encompass more than 39,000 doctors.
ALSO ON NJBIZ: