4 Key ACO Year-One Returns from CIGNA Accountable Care Effort

Tuesday, September 6th, 2011
This post was written by Patricia Donovan

CIGNA reports four key improvements from its ACO approach with Medical Clinic of North Texas:

  • Avoidable emergency room visits continue downward trend, seven percent better than market;

  • Following evidence-based medicine continues to improve, six percentage points better than market;

  • Medical cost trend is more than two percentage points better than market;

  • Diabetes is better controlled, will improve long-term health and lower medical costs.

    In a recent press release, CIGNA, which shares patient-specific data with the clinic that identifies individuals who could benefit most from additional outreach and follow-up care, credits care managers with much of the program’s first-year success:

    The care coordinator, who is fundamental to the program’s success, is a nurse on MCNT’s staff who uses the CIGNA data and reaches out to these patients.

    “We’re able to share information with MCNT about potential gaps in care, such as which patients might be overdue for a mammogram or colonoscopy, or which patients with diabetes are missing important blood tests or didn’t refill a prescription,” said Dr. Mark Netoskie, senior medical director for CIGNA in Texas. “Using this information, MCNT’s care coordinator can reach out to these patients to ensure they get the care they need, which results in higher compliance with evidence-based medicine guidelines and a healthier population.”

    During the program’s first year, MCNT’s enhanced care coordination improved control of A1c blood sugar levels in diabetes patients by nearly 3 percent. Management of cholesterol and blood pressure levels also improved for these patients. Helping people with diabetes control their disease and manage their overall health can have significant long-term benefits, including longer, more productive lives and lower medical costs.

    As part of the program, MCNT also improved patient access to care by expanding office hours, contributing to more primary care office visits.

    Learn how CIGNA Pharmacy Management improves medication adherence in its population.

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