Cigna 2012 Annual Report Download - page 29

PART I
ITEM 1 Business
health events may have additional customer service needs. As of coordinate end-to-end care for a defined population of patients and
December 31, 2012, Cigna operated 13 call centers and a virtual team share timely, patient-specific medical information with the physician
that customers can call toll-free about their health care benefits, group. Each CAC has an embedded care coordinator that supports
wellness programs and claims. Ten of these call centers are available patient care and care plan development. The coordinator uses patient-
24 hours a day, 365 days a year. The remaining three, that service specific information supplied by Cigna to conduct proactive outreach
HealthSpring providers and customers, operate for extended hours to coordinate care for patients in three categories: i) patients who are
during high volume periods to accommodate customer demands. being discharged from the hospital who are at risk for readmission;
Cigna offers the ‘‘My Personal Champion’’ program that provides ii) patients with high priority gaps in care; and iii) patients with high
qualified customers with a dedicated point of contact. Personal health risk scores based on Cigna’s predictive models. This approach
Champions serve as a resource for benefits and claims questions, assist leverages the role of the physician as the trusted advisor. With the
with navigating the complex health care industry, and offer education innovative physician engagement models acquired with HealthSpring,
and support to customers and their families. As of December 31, we utilize a variety of business arrangements that shift the physician’s
2012, approximately 5 million Cigna customers had access to the My reimbursement from the traditional fee-for-service approach to one
Personal Champion program. that is focused on rewarding quality medical outcomes and an
enhanced customer experience at a lower cost. In these arrangements,
With over 1.2 million customers across the globe, Cigna’s the physician group shares financial risk with Cigna. The
international health care business continues to be a leader in providing HealthSpring clinical model also includes outreach to new and at-risk
quality customer service. Its globally mobile customers have access to customers to ensure they are accessing their primary care physician.
medical professionals, case management experts and claims specialists
24 hours a day, 365 days a year, through service centers dedicated to Cigna also continues to engage in a variety of other medical quality
their unique needs. Cigna uses a wide range of measurement tools to activities, including: credentialing medical health care professionals
better understand customers’ needs – ranging from quick 5-minute and facilities that participate in Global Health Care’s Managed Care
surveys of a customer’s call-center experience to more elaborate and PPO networks as well as developing the Cigna Care Network
SM
tracking of loyalty as measured by customers’ likelihood to refer Cigna specialist physician designation described below.
to a friend. Participating Provider Network. Cigna has an extensive network of
Technology. Global Health Care understands the important role that participating health care professionals and hospitals, as well as other
information technology plays in improving the level of service that facilities, pharmacies and vendors of health care services and supplies.
Cigna can provide to its customers, which is critical to the continued In most instances, Global Health Care contracts directly with the
growth of the Company’s health care business and its focus on participating hospital, health care professional or other facility to
customer-centricity. Accordingly, Global Health Care continues to provide covered services to customers at agreed-upon rates of
invest in its information technology infrastructure and capabilities reimbursement. In some instances, however, Global Health Care
including innovative mobile tools and Internet-enabled technology companies contract with third parties for access to their provider
that support Global Health Care’s focus on providing customers with networks and care management services. In addition, Global Health
a personalized experience in making health care decisions and Care has entered into strategic alliances with several regional managed
leveraging customer insights to drive the Company’s strategy and care organizations (Tufts Health Plan, HealthPartners, Inc., Health
mission. Alliance Plan, and MVP Health Plan) to gain access to their provider
networks and discounts.
Cigna Medical Group. Cigna Medical Group is the multi-specialty
Quality Medical Care
medical group practice division of Cigna HealthCare of Arizona, Inc.
Global Health Care’s commitment to promoting quality medical care that delivers primary care and certain specialty care services through
to its customers is reflected in a variety of activities. Most recently, 25 medical facilities and approximately 190 employed clinicians in the
Cigna has focused on collaborating with physicians and other health Phoenix, Arizona metropolitan area. Twenty-two of these multi-
care professionals and facilities with the goal of improving quality and specialty health care centers and their affiliated primary care
customer satisfaction while lowering medical costs. This focus has physicians have received the top level of accreditation (level 3) from
manifested itself through the rapid expansion of collaborative the National Committee for Quality Assurance (NCQA) a private,
accountable care organizations developed by Cigna as well as the nonprofit organization dedicated to improving health care quality.
innovative physician engagement models acquired with HealthSpring Cigna Medical Group currently holds the highest level of this
in 2012. As of December 31, 2012, almost one million medical accreditation for the greatest number of practices and physicians in
customers are serviced by physicians compensated under these types the state of Arizona.
of arrangements.
Cigna Care Network
SM
. Cigna Care Network is a benefit design option
Collaborative Accountable Care Organizations (CAC). As of available for Global Health Care administered plans in 69 service areas
December 31, 2012, Cigna has established over 50 CACs, and expects across the U.S. Cigna Care Network’s designated physicians are a
to continue to expand these arrangements. The overall objective of subset of participating physicians in certain specialties who are so
these organizations is to improve the quality of care and service designated based on specific clinical quality and cost-efficiency
experience for customers while lowering their costs, resulting in selection criteria. Customers pay reduced co-payments or
improved overall value. The goal is to identify health care delivery co-insurance when they receive care from a specialist designated as a
organizations (medical groups and hospital organizations) that can
CIGNA CORPORATION - 2012 Form 10-K 7