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Monday, January 25, 2021

Catalyst Health Network improves quality, lowers costs through Cigna Collaborative Care program

New results from Cigna’s Collaborative Care initiative with Catalyst Health Network indicate that the program continues to improve health outcomes for North Texas residents while providing better affordability and an enhanced patient experience, according to a company news release.

The initiative has helped Catalyst Health Network deliver a higher level of care to more than 26,000 Cigna customers in North Texas. This includes a strong emphasis on improved quality, lower use of the emergency room for non-emergencies, reduced hospital admissions and better coordination among extended care teams including nurses, pharmacists and social workers, the release stated.

Catalyst Health Network’s quality index — a measure of how well doctors comply with evidence-based medical guidelines — was 5 percent higher than the market for the year ending March 31, 2017.

Additionally, in a region that is among the most expensive in the nation for health care, Catalyst is also lowering the group’s total medical cost 5.6 percent better than the market, the results indicate.

When compared to the market, several factors drove Catalyst Health Network’s results, including:

— 7.3 percent higher rate of eye exams for patients with diabetes. These exams can help prevent blindness, which is a frequent complication of diabetes.

— 4.5 percent more diabetes patients whose blood sugars are well-controlled

— 6.9 percent better in the appropriate use of antibiotics

— 10.9 percent better use of the appropriate imaging use in back pain

“We congratulate Catalyst Health Network for its commitment to Cigna Collaborative Care and for its strong focus on quality improvement,” said Fredrick Watson, M.D., senior medical director for Cigna in Texas and Oklahoma, in the release. “These results show what’s possible when a health plan and health care professionals collaborate to achieve common goals: better health and a better experience for the people we jointly serve.”

Overuse of emergency room (ER) services, especially for non-emergencies, has been found to contributes to increased medical costs.

Catalyst Health Network took a number of steps to reduce ER use – including extended office hours, patient education and collaboration with hospitals – which produced strong results:

— Hospital admissions 19 percent lower than market

— Emergency room visits 11 percent lower than market

“We are incredibly proud of the results achieved as we continue our commitment to improve quality health care while reducing patient costs,” said Christopher Crow, M.D., president of Catalyst Health Network, in the release. “Our relationship with Cigna is making a positive impact on our patients’ health and the care they receive from our physicians, which is a direct result of our collaborative effort to transform health care in our communities.”

The Catalyst Health Network Care Team uses patient-specific data from Cigna to help identify individuals being discharged from the hospital who might be at risk for readmission, as well as people who may be overdue for important health screenings or who may have skipped a prescription refill.

The physician-led care team also helps patients get the follow-up care and needed screenings, in addition to identifying potential complications related to medications and helping to prevent chronic conditions from worsening.

Cigna Collaborative Care is the company’s approach to accomplish the same health goals as accountable care organizations (ACOs).

The company now has more than 190 of these arrangements with primary care groups, multi-specialty groups and integrated delivery systems. They span 31 states, reach more than 2.2 million commercial customers and encompass more than 84,000 doctors, including more than 47,000 primary care physicians and nearly 37,000 specialists.

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