Palo Alto Medical Foundation and Cigna Collaborate to Create Cigna's First Accountable Care Program in California

Cigna (NYSE:CI) and the Palo Alto Medical Foundation (PAMF), a not-for-profit health care organization that is a pioneer in the multispecialty group practice of medicine, have 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. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs.

“It is critical that insurers and health care providers work more closely together to improve service to patients”
PAMF is part of the Sutter Health family of not-for-profit hospitals and physician organizations that share resources and expertise to advance health care quality. A pioneer in outpatient medicine, PAMF operates more than 40 individual medical clinics that together serve over 750,000 patients in communities covering Alameda, San Mateo, Santa Clara and Santa Cruz counties.

This patient-centered collaboration is Cigna's first accountable care initiative in California. It links doctors, hospitals and a single health plan together with the goal of reducing health care costs by improving patients’ health.

The program will benefit as many as 21,000 individuals covered by a Cigna PPO health plan who receive care from PAMF’s more than 1,000 primary and specialty care physicians, including those in its affiliated independent physician association, Mills-Peninsula Medical Group.

“Cigna is a national leader in accountable care, which is why we are enthusiastic about working with the company as part of this program,” says PAMF Chief Executive Officer Richard Slavin, M.D. “We believe this arrangement offers a wonderful opportunity for us to improve health care quality, lower medical costs and help our patients lead healthier and more productive lives.

“PAMF is a pioneer in the adoption of electronic health record technology to coordinate care, reduce errors and improve communication between clinicians and patients. These technologically advanced capabilities make PAMF uniquely suited to a collaborative accountable care initiative,” Dr. Slavin adds.

“It is critical that insurers and health care providers work more closely together to improve service to patients,” says Cecilia Montalvo, regional vice president of strategy and business development at PAMF and the Peninsula Coastal Region of Sutter Health. “We believe that by partnering with Cigna, we are entering into the type of health plan-health care provider collaboration that will serve as a model for the future in rewarding innovation and quality of care.”

Patients will continue to go to their current physician and will automatically receive the benefits of the program. There also 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 or heart disease.

Critical to the program’s benefits are registered nurses, who serve as clinical care coordinators to help patients navigate their health care system. The care coordinators will reach out to patients who are overdue for important health screenings or who may have skipped a prescription refill. In addition, patients who may be at increased risk of developing health problems in the future will be offered preventive services such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight loss and stress management.

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