SANTA CLARA, Calif. — 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.
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.
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.