Dallas-based Baylor Scott & White Quality Alliance (BSWQA) has joined forces with Cigna (NYSE: CI) in a population health initiative that aims to improve quality, affordability and the patient experience for approximately 40,000 individuals who are covered by a Cigna health plan and receive care from BSWQA physicians.
The new arrangement builds upon and expands a longstanding collaboration with Baylor Scott & White Health. The initiative includes BSWQA’s accountable care organization (ACO), which comprises more than 5,000 primary and specialty care physicians, 48 hospitals, post-acute care facilities and other health care stakeholders agreeing to be jointly accountable for improving quality, managing the health of patient populations and reducing health care costs.
The collaboration is part of Cigna Collaborative Care, which is focused on improving health outcomes using population health strategies that include care coordination, data analytics and provider engagement. In places where it's been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs by:
- Helping to close gaps in care, such as missed health screenings or prescription refills;
- Assisting those with chronic illness to better understand and manage their condition(s);
- Reinforcing the appropriate use of hospital emergency rooms;
- Helping to increase the number of preventive health visits; and
- Helping to improve follow-up care for people transitioning from the hospital to home.
"Baylor Scott & White Quality Alliance looks forward to working with Cigna to advance population health initiatives that are already proving to change health care for the better," says Cliff Fullerton, M.D., president of BSWQA. "We continue to evolve the way we manage the health of patient populations and create a more nuanced care model that can be tailored to the specific needs of the Cigna customer. We are confident in our abilities to bring value through quality and efficiency improvements that will ultimately reduce costs, enrich the lives of members and benefit the communities we serve."
Cigna Collaborative Care creates a cooperative environment where doctors and the health plan work alongside each other. The collaboration between BSWQA and Cigna creates the opportunity for a more seamless experience for patients, improving their well-being while lowering their health care costs. This is accomplished by:
- Matching the individual with a primary care doctor;
- Coordinating care services through a centralized team of nurse care managers, health coordinators and social workers that assists patients in understanding and complying with their doctor's treatment plan;
- Sharing data securely among primary and specialty care doctors, hospitals, laboratories and post-acute care facilities as well as the health plan providing individuals with a higher level care experience;
- Aligning incentives so that doctors are rewarded for improving health care quality and achieving efficiencies resulting in medical cost savings.
BSWQA's results from managing the health of employees from a current large employer group in the North Texas area demonstrate the positive health and cost outcomes achievable through this collaborative approach to care. Reported results and expected trends for the group's employee population over a five-year period include:
- 13 percent fewer hospital admissions due to better coordinated care
- 19 percent higher use of in-network services for better quality and affordability
- 0 percent medical cost trend (compared to market)
- $57 million in savings
"We've had a long and successful relationship with Baylor Scott & White Health and we're delighted to expand that relationship by bringing Cigna Collaborative Care to BSWQA patients who are Cigna customers," said LaMonte Thomas, president of Cigna's North Texas market. "With a focus on the quality of care our customers receive, this model rewards doctors for healthier populations and improved medical costs. That's better value for individuals, families, employers and doctors."
Cigna will compensate physicians who are part of the initiative for the medical and care coordination services they provide. Physicians may also be rewarded with additional "pay for value" reimbursement if they meet targets for improving quality and lowering medical costs.
Cigna has been at the forefront of value-based reimbursement since 2008 and now has 189 Cigna Collaborative Care arrangements with primary care groups, multi-specialty groups and integrated delivery systems. They span 32 states, reach more than 2.1 million commercial customers and encompass more than 100,000 doctors, including more than 48,000 primary care physicians and nearly 52,000 specialists.
Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has more than 95 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
About Baylor Scott & White Quality Alliance
BSWQA is an established accountable care organization (ACO) affiliated with Baylor Scott & White Health (BSWH), the largest not-for-profit health system in Texas. BSWQA is comprised of over 5,000 primary and specialty care providers, 48 hospitals, post-acute care facilities and other health care stakeholders agreeing to be jointly accountable for improving quality, managing the health of patient populations and reducing health care costs. Beginning operations in 2013, BSWQA has successfully implemented population health strategies that have resulted in significant improvements for quality and cost reductions.
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About Baylor Scott & White Health
As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,100 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit: BSWHealth.com