BLOOMFIELD, Conn., Aug. 10, 2005 /PRNewswire-FirstCall/ -- CIGNA HealthCare announced today that it is expanding and enhancing its benefit plan designs that offer incentives to consumers for selecting specialists who meet or exceed certain health care quality and efficiency measures. The CIGNA Care Network(R) will grow to sixteen markets around the country, giving consumers the option to choose from among three cost-sharing designs based on their choice of a specialist.
“There is a strong link between the quality of health care a person receives and the resulting costs of that care,” said Jeffrey Kang, M.D., chief medical officer for CIGNA HealthCare. “CIGNA Care Network designated specialists have demonstrated superior performance against key quality and efficiency measures that may lead to improved clinical outcomes and cost savings for consumers and employers. This plan design gives members the information they need to make informed decisions and then provides them with positive financial incentives to encourage them to seek care from these providers without limiting choice.”
CIGNA Care Network benefit plans provide members with information that helps them make health care decisions and encourages them to select a physician based on quality and/or efficiency measures. The plans feature flexibility and choice by:
-- Allowing members continued access to all contracted specialists in the network -- Giving members the choice to see any specialist they choose based on their benefit plan -- Providing that co-insurance/payment level for members who want to see a non-CIGNA Care Network in-network physician remain at the standard in-network level established by their employer -- Providing savings to members who see a CIGNA Care Network designated specialist through a lower co-payment or co-insurance level than the standard in-network level
While benefit plans vary by employer, Kang said he expects most employers to establish a consumer cost-sharing difference of $10-$30 per office visit between the standard in-network co-payment or co-insurance amount and the highest level of benefits available for selecting a CIGNA Care Network specialist physician. Members have the option to select a specialist designated as a CIGNA Care Network physician and pay the lowest co-payment or co-insurance level, or they can choose to see an in-network, non-designated specialist at the standard co-payment or co-insurance amount, or an out-of- network specialist at a higher co-insurance rate. In addition, the CIGNA Care Network makes referrals from primary care physicians seamless.
“As one of the largest primary care physician groups in Central Florida, we recognize that it is important that consumers receive detailed performance information about physicians and have the ability to select from an array of physicians based on real data and their own preferences,” states Vipin Popat, M.D., Chief of Internal Medicine and Medical Director for Physician Associates. “The CIGNA Care Network gives consumers knowledge and flexibility to make appropriate health care decisions for them and their families. Additionally, the CIGNA Care Network is designed to work seamlessly should primary care providers need to refer their patients to specialty physicians.”
Physicians are evaluated for CIGNA Care Network designation based on in- depth measures from third party organizations dedicated to quality of care and cost effectiveness. Evaluation includes 21 specialties accounting for approximately 95 percent of total specialty care and 60 percent of all medical/pharmaceutical spending. Specialists recognized by the NCQA in heart, stroke or diabetes care automatically receive CIGNA Care Network designation. Other measures for designation as part of the CIGNA Care Network include board certification and physician efficiency based on Episode Treatment Group methodology, an industry standard. Evaluation also includes performance against national quality standards established by the Ambulatory Care Quality Alliance to ensure that those who rank in approximately the top five percent receive CIGNA Care Network designation.
“We are pleased CIGNA HealthCare is including NCQA physician recognition in the information it provides to consumers and as criteria for designation in its CIGNA Care Network benefit plan,” adds Jeff Hanson, Chairman of Bridges to Excellence and regional healthcare manager for Verizon Communications. “This is the same recognition program that underlies our Bridges to Excellence physician pay for performance program, and it is important that both physicians and members are given consistent information on measurement standards and be rewarded on that basis.”
The new enhanced benefit plan designs will be available in the following markets for plans taking effect January 1, 2006: Phoenix, Dallas-Fort Worth, Houston, Miami, Orlando, Tampa, Richmond (Virginia), Greenville, Spartanburg and Columbia (South Carolina), Maine (all areas) and the metropolitan New York area, which includes northern New Jersey and Fairfield County (Connecticut). The CIGNA Care Network will also be offered in Los Angeles and Orange County (California) for PPO and CIGNA HealthCare’s Open Access Plus products only beginning January 1, 2006.
In addition to information about specialists, CIGNA HealthCare also provides members a 24-hour Health Information Line, personalized health coaching through its CIGNA Health Advisor(SM) program and access to WebMD Health’s comprehensive suite of online health tools including an online health risk assessment. CIGNA HealthCare’s online consumer decision-support tools include:
Hospital Value Tool -- Consumers can use an integrated online tool to help them choose a hospital. The tool’s “star-based” health care patient outcome and cost efficiency scores are based on data for hospital-based treatments of 19 medical procedures and conditions from both CIGNA HealthCare and Select Quality Care(TM), one of the nation’s leading Web-based tools for accessing and comparing quality data about hospitals.
Hospital Comparison Tool -- CIGNA HealthCare members can get detailed quality information to evaluate and compare hospitals on more than 150 hospital-based procedures and conditions through Select Quality Care, available through the myCIGNA.com personalized web portal.
DrugCompare(TM) from WebMD -- Members may compare medications or classes of medications for potential side effects, drug interactions or contraindications, and alternative medications, such as available generic medications.
CIGNA HealthCare, headquartered in Bloomfield, CT, provides medical benefits plans, dental coverage, behavioral health coverage, pharmacy benefits, and products and services that integrate and analyze information to support consumerism and health advocacy. “CIGNA HealthCare” refers to various operating subsidiaries of CIGNA Corporation . Products and services are provided by these operating subsidiaries and not by CIGNA Corporation.
CIGNA HealthCare
CONTACT: Gwyn Dilday of CIGNA HealthCare, +1-818-500-6370 orGwyn.Dilday@cigna.com
Web site: http://www.cigna.com//
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