Coordinated Care Efforts Continue to Expand
Facey Medical Group has stated a new partnership with Cigna to improve coordinated care efforts.
- Throughout the healthcare landscape, a number of organizations are making strides to improve coordinated care efforts within their own facilities. In many cases, this means partnerships with healthcare providers that push for the same goals.
In an interview with RevCycleIntelligence.com, Teresa David, the Chief Operating Officer of Facey Medical Foundation spoke about a new partnership with Cigna that aims to improve coordinated care and how it came to be came to be.
RevCycleIntelligence: What made Facey Medical Group choose to partner with Cigna?
Teresa David: Facey enjoys a longstanding relationship with Cigna. Facey takes care of almost 3,000 Cigna HMO members and 2,500 Cigna PPO members. We always look for new opportunities to partner with the payers to deliver affordable, coordinated care.
RCI: Are you partner with other payers also for coordinated care efforts?
TD: Yes; Facey is a multispecialty medical group that embraced the coordinated care model back in the early 1980’s when Facey entered into contracts with HMOs. Coordinated care is one of the essential elements of our integrated care model. We provide this coordination of care process across all Facey patients regardless of payor. Facey has a system of care in place that is supported by an infrastructure that includes a shared electronic medical records system across the medical group, health information exchange with the Providence Hospitals and contracted health plans, and a care management process that manages care transitions across the care continuum (hospital, SNF, home).
RCI: How long has coordinated care been something Facey has been focused on?
TD: We have been enhancing this model of care for a long time since Facey has assumed financial risk by accepting professional HMO capitation payments for physician services delivered for over 25 years. We continue to refine the model through expanded hospitalist and nocturnist programs, more resources dedicated to high risk case management and discharge planning, and increased utilization of home visits, home palliative care, and hospice.
RCI: What are the major challenges that this partnership and the others will address?
TD: The Cigna collaborative care program is offered to PPO members. By nature of the product, PPO members are not required to select a primary care physician and are for the most part able to see any specialist in the broad PPO network. Facey and Cigna will encourage Facey patients to see physicians within the Facey contracted network rather than seek care outside of our coordinated model.
The challenge will be for Facey to quickly engage the patients in their care plan. This personal connection with the expanded Facey and Cigna joint care team should enhance the patient’s willingness to allow Facey to coordinate all aspects of their care.
RCI: How will it impact the medical group’s revenue cycle?
TD: Our reimbursement will remain the same, and we will also have the opportunity to earn additional compensation if we meet targets for improved quality and cost.
RCI: What are the ultimate benefits and goal of this partnership?
TD: The goal of this partnership is for Cigna and Facey to combine resources and collaborate to improve all aspects of a patient’s medical care. This will be accomplished through enhanced reporting tools provided by Cigna that will notify Facey of ER and hospital admits on a real time basis as well as information on pharmacy and preventive health utilization.
Through this expanded information set, Facey will be able to proactively outreach to our attributed patients to schedule preventive health visits, schedule ambulatory follow-up visits post hospitalization, and offer disease management programs for conditions such as diabetes and heart disease. Cigna and Facey will both employ clinical resources to develop our care coordination staff and assist the patients.
RCI: Where their any industry trends that impacted the decision to create this partnership?
TD: The PPO ACO model has gained traction in California over the past few years so we thought it was time for us to embrace this new trend.
