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Home / News & IndustryManaged Care Insight and Analysis
Updated: April 13, 2010
CIGNA, Texas Clinic Launch Patient-Centered Medical Home Pilot Program

CIGNA and Medical Clinic of North Texas (MCNT) have embarked on a patient-centered medical home pilot program, embracing the best elements of the medical home-based model and patient-centered medical home model of care

The parties said it is the first such commercially sponsored program in Texas. MCNT is a Dallas-Fort Worth-based physicians’ group with more than 120 board-certified primary care physicians and specialists

They believe such an approach to be comprehensive, accountable and collaborative and will lead to improved patient access, better continuity and coordination of care, improved quality of care for patients and lower medical costs.

"It is critical that we get on a path toward paying more for healthcare that is better coordinated and leads to fewer complications and improved results – at a lower overall cost," said Dr. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution, and former administrator of the Center for Medicare and Medicaid Services.

The program is focused on individuals, receiving care from MCNT’s primary care physicians, practicing family medicine, internal medicine and pediatrics. Currently, more than 10,000 individuals covered by a CIGNA health plan can receive care from MCNT primary care physicians. Individuals will simply access care from one of the 82 MCNT primary care physicians participating in the pilot program

In a patient-centered medical home model of care, a primary care physician is responsible for monitoring and coordinating all aspects of an individual’s medical care. Expanding access and improving care coordination are the keys to the concept.

"Today’s healthcare system is too complex and fragmented, and the traditional physician payment structure de-emphasizes primary care by rewarding specialization and paying doctors to perform more procedures rather than delivering better outcomes and providing greater value to their patients," said Dr. Ken Phenow, CIGNA’s senior medical director for MCNT.

Primary care physicians affiliated with MCNT will be paid as usual for the medical services they provide and may also be rewarded through a P4P structure. According to Phenow, emphasizing the value of the primary care physician as the overall coordinator of their patients’ health will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.

CIGNA is providing funding to establish a process of care coordination led by a registered nurse working with a team of professionals supported by MCNT, as well as its data and clinical tools.

The ongoing initiative will be evaluated after at least 12 months.

CIGNA already participates in several medical home initiatives throughout the country, including multi-payer pilots in Colorado, Pennsylvania and Vermont, and a CIGNA-only pilot in New Hampshire. It has been a member of the Patient-Centered Primary Care Collaborative since October 2007.

For more information on CIGNA, visit www.cigna.com.

Address: Medical Clinic of North Texas, 9003 Airport Freeway, Suite 300, N. Richland, TX 76180; (817) 514-5200, www.mcnt.com.


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