The latest results from a collaboration between Cigna and Santa Clara
County IPA (SCCIPA) show that the program continues to drive better
health care quality for nearly 18,000 Silicon Valley residents while
achieving significantly better affordability.
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SCCIPA enhances care by using patient-specific data from Cigna to help
identify individuals being discharged from the hospital who might be at
risk for readmission, as well as people who may be overdue for important
health screenings or who may have skipped a prescription refill. The
physician-led care team also helps patients get the follow-up care or
screenings they need, identifies potential complications related to
medications and helps prevent chronic conditions from worsening.
While SCCIPA already beats the market in affordability with total
medical costs that are 18 percent below market average, the medical
group’s cost trend was 2.6 percent lower than the market trend during
the period ending Sept. 30, 2018.
At the same time, the group’s quality score improved by double digits –
nearly 20 percentage points, led by better care of patients with cardiac
conditions, diabetes, depression and those requiring specific preventive
screenings.
Numerous factors contributed to SCCIPA’s strong performance results
compared to the market, including:
- Hospital readmissions were 23 percent lower than market
-
Inpatient admissions among all services were 10 percent lower than
market - Emergency room visits were 9 percent lower than market
-
Advanced imaging (CT scans and MRIs) were used 32 percent less than
market -
Inpatient total medical cost (per Cigna customer per month) was 20
percent lower than market
“As a risk-bearing network of more than 800 physicians, we’re very
pleased with these positive results,” said John Kersten Kraft, M.D.,
president of SCCIPA. “SCCIPA is devoted to improving the measurable
quality of medical intervention received by our patients while
controlling the cost of their care. We value our strong and
exceptionally collaborative relationship with Cigna. Without this
relationship, these results could not be achieved. Together, we are
having a very positive impact on the health of our patients.”
“When health plans and health care providers work together toward a
common goal, the result is better health and affordability for the
people we jointly serve,” said Ken Phenow, M.D., M.P.H, market medical
executive for Cigna in Northern California. “We congratulate Santa Clara
County IPA for its laser focus on quality improvement that drove these
outstanding results.”
Since Cigna began collaborating with SCCIPA in 2014, the group has
demonstrated some of the most consistent performance, not only among
other medical groups in Northern California and Cigna’s Western Region,
but also among the more than 225 Collaborative Care arrangements Cigna
has with provider groups nationwide. In 2018, SCCIPA was the top
performing Cigna Collaborative Care group nationally.
In addition to its Collaborative Care arrangement with Cigna, SCCIPA is
also part of an alliance between Cigna and Good Samaritan Health System,
which includes Regional Medical Center of San Jose and Good Samaritan
Hospital. The alliance launched in January 2018 and offers a customized
network of primary care doctors, specialists and hospitals that provide
high value care.
About Santa Clara County IPA
Santa Clara County IPA (SCCIPA) has been providing exceptional
healthcare services for more than 30 years. More than 240 primary care
physicians and 600 specialists are focused on delivering the highest
quality of care, while driving lower cost of care for more than 90,000
members of major HMOs, PPOs, ACOs and Medicare Advantage programs.
SCCIPA’s mission is to connect patients to independent doctors who are
passionate about providing personalized care. The diverse network
includes access to 13 urgent care centers, 10 hospitals, radiology,
clinical labs, physical therapists, and case managers dedicated to
providing care with a purpose. SCCIPA offers a multitude of services for
members and is known for its Care Concierge program. The program is led
by a team of clinicians and is designed to engage patients and promote
healthy habits, behavioral change, improved health, and ultimately lower
cost of care by helping members be at their best. Visit www.sccipa.com.
About Cigna
Cigna Corporation (NYSE: CI) is a global health service company
dedicated to improving the health, well-being and peace of mind of those
we serve. Cigna delivers choice, predictability, affordability and
quality care through integrated capabilities and connected, personalized
solutions that advance whole person health. All products and services
are provided exclusively by or through operating subsidiaries of Cigna
Corporation, including Cigna Health and Life Insurance Company,
Connecticut General Life Insurance Company, Life Insurance Company of
North America, Cigna Life Insurance Company of New York, Express Scripts
companies or their affiliates. 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 over 30 countries and jurisdictions, and
has more than 160 million customer relationships throughout the world.
To learn more about Cigna®, including links to follow us on
Facebook or Twitter, visit www.cigna.com.
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