Wellmont Medical Associates Collaborates With Cigna In Initiative That Advances Quality Of Patient Care

Wellmont Medical Associates is expanding its collaboration with Cigna (NYSE: CI) by participating in the health service company's Collaborative Care program to ensure a broad continuum of care for patients.

The Cigna Collaborative Care initiative also devotes considerable attention to helping prevent chronic conditions from worsening and directing patients to appropriate programs for illness management and lifestyle modification.

John Howard, president and chief executive officer of Wellmont Medical Associates, said this collaborative care program is a logical extension of the productive relationship between Wellmont and Cigna.

"As the leader in delivering superior care in our region, we welcome the opportunity to work with the excellent team at Cigna to ensure patients receive treatment when they are sick but also have the tools to maximize their health in their daily lives," Howard said. "We agree wholeheartedly with the principles of this program, which dovetail nicely with many initiatives in our care regimen."

Central to Cigna's program are registered nurse clinical care coordinators employed by Wellmont Medical Associates, who are empowered to help patients navigate the healthcare system. They use patient-specific data from Cigna to help identify patients being discharged from a hospital who might be at risk for readmission. This is important for both organizations, as a key component of the Affordable Care Act revolves around preventing many readmissions.

These coordinators also keep an eye out for patients who might be overdue for important health screenings or might have skipped a prescription refill. They help patients receive needed follow-up and preventive care and identify potential complications related to medications.

Other ways coordinators assist patients include health education and patient referrals to clinical support programs available from Cigna and Wellmont. Among these programs are chronic condition management for diabetes and heart disease and lifestyle programs to assist with tobacco cessation and weight and stress management.

Cigna compensates Wellmont Medical Associates for providing these coordination services and meeting targets to improve quality and lower costs through a pay-for-value reimbursement structure.

"We share a common goal with Wellmont Medical Associates of transforming the healthcare delivery system from one that pays physicians based on the volume of healthcare services to one that focuses on improved outcomes and lower cost," said Renee McLaughlin, M.D., Cigna's senior medical director for Tennessee. "In other words, we are partnering with Wellmont Medical Associates to help deliver higher-value health care."

Howard agrees, noting Wellmont has been at the forefront of pay-for-performance agreements with insurance companies. He said Wellmont has been the region's leader in developing high-quality, low-cost models of care that effectively serve patient needs.

Cigna has established collaborative care initiatives with 100 organizations across the country, and this new program with Wellmont Medical Associates will provide Cigna customers with prompt, seamless service while giving them access to enhanced care coordination.

Those who use Cigna for their insurance can also use multiple forward-thinking programs and services that cater to improving their lives. The Wellmont Health Coach brings a host of screenings, tests and evaluations to many area locations, and Business Health Solutions offers a broad array of programs that enable company to reduce expenses by having healthy employees.

Wellmont's desire for everyone in the region to achieve good health inspired the creation of Wellmont LiveWell, a free web-based program designed to improve the region's health status. With the support of multiple businesses, this initiative encourages people to commit to important habits, such as regular exercise; healthy diets; maintaining proper blood pressure, cholesterol and blood sugar levels; and not smoking.

Earlier this year, Wellmont created an electronic health record in which physicians and other caregivers can review a patient's history of care regardless of which facility in the health system the treatment occurred. Patients can also log on to www.MyWellmont.org to review a significant portion of their medical record.

"We are excited to embark on this endeavor with Cigna and advance the quality of care and quality of life in our region even further," said Denny DeNarvaez, Wellmont's president and CEO. "We have made tremendous strides with Cigna customers through our focused network and a variety of innovative programs and anticipate this progress will continue to escalate through this collaboration."