Texas Health Launches New Accountable Care Initiative

Texas Health Resources, Texas Health Physicians Group, and Cigna have launched a collaborative accountable care initiative, the groups announced Monday, in an attempt to improve patient access to healthcare and enhance care coordination.

The program launched on January 1, and is Cigna’s fifth accountable care initiative in North Texas.

“[Texas Health Physicians Group’s] physicians and clinical team already deliver quality, patient-centered care that helps our patients live healthy and productive lives,” Shawn Parsley, president of THPG, said in a statement. “We’re pleased to join Cigna in this partnership because the addition of immediate access to care coordinators will provide our patients with the resources they need to manage and improve their chronic conditions.”

The ultimate goal of the collaboration is to enhance the overall well-being of the population through a coordinated approach to all aspects of health, officials said. The approach is aimed at accomplishing the same population-health goals as accountable care organizations. It will benefit more than 17,000 individuals covered by a Cigna health plan who also receive care from approximately 250 THPG primary-care physicians.

Patients who currently receive care from a THPG primary care physician will automatically receive the benefits of the program. Program benefits also will be available to any future Cigna customers who get care from a THPG primary care physician.

“Cigna has a strong track record of collaborating with North Texas physician practices to reshape the healthcare delivery system,” said LaMonte Thomas, Cigna’s president and general manager for North Texas and Oklahoma. “We believe that when we reward doctors for results, rather than for volume of care, we’re helping to create a healthcare system that produces value for patients, physicians and employers.”

Under the program, THPG physicians will monitor and coordinate all aspects of an individual’s medical care to proactively manage interventions and improve overall well-being. Critical to the program’s benefits are care coordinators who help patients with chronic conditions navigate the healthcare system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the physicians and Cigna, with the goal of providing a better experience for the individual.

The announcement comes on the heels of last week’s news that nearly half of the organizations in CMS’ largest accountable care organization test have slowed Medicare spending, but just 29 of 114 ACOs saved enough to receive bonus payments.

Medicare spending was lower than projected among 54 of the ACOs during the first 12 months of the effort, while 29 ACOs reduced Medicare spending enough to keep $126 million. CMS did not identify which organizations earned savings, but said the agency would eventually publish details on individual ACOs’ performance. Medicare will keep an additional $128 million in savings.

“These innovative programs are showing encouraging initial results, while providing valuable lessons as we strive to improve our nation’s healthcare delivery system,” HHS Secretary Kathleen Sebelius said. “Today’s findings demonstrate that organizations of various sizes and structures across the country are working with their physicians and engaging with patients to better coordinate and deliver high quality care while reducing expenditure growth.”