CIGNA/Piedmont Physician Group Collaborative Accountable Patient Centered Medical Home

Region Within State: 
Atlanta
Project Category: 
Insurer-Based
PROJECT STATUS
Target Start Date: 
Tuesday, June 1, 2010

CIGNA's Collaborative Medical Home initiative with Piedmont is designed to use patient level actionable data and trend data to support practice actions with the goals of improving quality of care, affordability of care and satisfaction.  This group is composed of 100 primary care physicians.

Along with a patient roster, CIGNA provides Piedmont with actionable data identifying high risk patients using predictive modeling information that incorporates care patterns and cost

. Piedmont provides “embedded case management services,” i.e., a nurse who helps to coordinate the care of the patient with the goal of improving quality and reducing avoidable ER visits and hospitalizations for this high risk group and others identified. CIGNA also provides Piedmont with electronic feeds of “gaps in care” where identified issues such as medication compliance or needed preventive health care can be addressed.. Clinical collaboration between CIGNA and Piedmont encourages patient access to CIGNA’s Health Management programs.

Type of Practices: 
Pediatrics
CONVENING ENTITY/PROJECT CONTACTS
Convening Organization Name: 
CIGNA HealthCare
Primary Contact: 
Karen Litle
E-mail: 
karen.litle@cigna.com
Additional Contact
Name: 
Harriet Wallsh
Mark Slitt- Media Contacts
Participating Organization Types: 
CIGNA; Piedmont Physician Group
EXPECTED OR ACTUAL DEMOGRAPHICS OF PARTICIPATING PRACTICES
Number of Practices: 
4
Number of Participating Physicians: 
93
Types of Practices: 
Family Practicce, Internal Medicine, Pediatrics
Health Plan Lines of Business Included: 
HMO, POS, PPO & Open Access
Overall Number of Covered Lives: 
10000
Consumer Involvement: 

None to date

PRACTICE TRANSFORMATION SUPPORT (INCLUDING TECHNOLOGY)
Services participating practices have added as a result of their participation: 

Piedmont Physicians Group supports various workgroups to implement operational strategies in support of the medical home concept, such as evidence based care guidelines, patient communications, access to services and optimizing workflows. An embedded care coordinator is being added to support patient care and care plan development; act as patient navigators; ensure patient transitions (i.e. post-hospital discharge, MD-MD) are smooth and completed; and support patient education, family inclusion, greater knowledge of CIGNA and community resources and their use as needed.

Payment Model: 

CIGNA support a blended payment model, using fee for service, enhanced care coordination fee for enhanced medical home care and outcomes based payment adjustment for improvements in quality and affordability of care.

PROJECT EVALUATION
Types of data to be collected : 

CIGNA's assessment process looks at quality, through evidence based measures and total medical cost improvements to drive a financial reward to the practice

Which of the data types are being shared?: 

Performance and patient actionable reports to identify patients at high risk and Gaps in Care