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PrimeHealth Physicians, LLC Collaborates With Cigna to Improve Health and Lower Costs in South Florida

CignaMIAMI – Cigna (NYSE: CI) has launched a collaborative care initiative with PrimeHealth Physicians, LLC that aims to improve patient access to health care, enhance care coordination, and achieve the goal of improved health,affordability and patient experience. With the launch of this initiative, which became effective July 1, Cigna now has eight collaborative care arrangements throughout Florida, with four in South Florida. PrimeHealth Physicians is the first independent medical group in South Florida.

“Through this type of collaboration we have the opportunity to help transform the health care delivery system”

Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The arrangement with PrimeHealth Physicians will benefit more than 5,300 individuals covered by a Cigna health plan who receive care from 45 doctors at PrimeHealth Physicians.

In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. The programs are helping to close gaps in care, such as missed health screenings or prescription refills, reinforcing the appropriate use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.

Prime Health Physicians“As each PrimeHealth physician provides coordinated, high-quality care to our patients, we are pleased to collaborate with Cigna to enable more coordinated care with other health care professionals while adding value and a better patient experience,” said Diego Saavedra, M.D., an internist in the Kendall area and chairman of PrimeHealth Physicians, LLC. “Our mission is to keep our patients healthy and to help them navigate the health care system when they need it. This collaboration with Cigna will help us do that.”

“Through this type of collaboration we have the opportunity to help transform the health care delivery system,” said Marco N. Vitiello, M.D., Cigna’s senior medical director for South Florida. “When we reward doctors for results and focus on prevention, wellness, health improvement and care coordination, we can create a system that works for everyone who uses, pays for or delivers health care.”

Under the program, PrimeHealth Physicians will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physicians and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from PrimeHealth will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes, heart disease and obesity.

Critical to the program’s benefits are the registered nurse clinical care coordinators, employed by PrimeHealth Physicians, who will help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the physician group and Cigna, which will ultimately provide a better experience for the individual.

The care coordinators will enhance 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 individuals who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators are part of physician-led care teams that will help people get the follow-up care or screenings they need, identify potential complications related to medications and help prevent chronic conditions from worsening.

Care coordinators can also help individuals schedule appointments, provide health education and refer people to Cigna’s clinical support programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.

Cigna will compensate PrimeHealth Physicians for the medical and care coordination services it provides. Additionally, the physician group may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.

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