PPO Accountable Care Organization Partnerships
Brown & Toland’s partnership with Cigna illustrates how we collaborate with health plans under ACO arrangements. The Cigna initiative is the first comprehensive, commercial PPO-based ACO with a San Francisco medical group. Called Collaborative Accountable Care (CAC) and consistent with the ACO premise, the program focuses on the value versus the volume of care as a solution to improve health and lower medical costs.
To create a patient-centered health care system, Brown &Toland uses clinical care coordinators to help patients who have chronic conditions or other health challenges navigate the healthcare system. Our care coordination team includes Brown & Toland nurses, physicians and other healthcare professionals.
Part of a physician-led team, our care coordinators leverage patient-specific data culled from both our systems and our health plan partner to:
- Caring for patients at risk for hospitalization by providing services and care to help prevent unnecessary admissions
- Identify and support patients discharged from the hospital who might be at risk for readmission
- Reach out to patients who may be overdue for important health screenings or who may have skipped a prescription refill
- Improve access to care on nights and weekends for non-emergency care needs through the After Hours Care network and nurse advice lines
- Provide our physicians in the Brown & Toland network with timely health information at the point of care
Our care coordinators also collaborate with health plan staff to:
- Help identify patients who may be at risk and enroll members in disease management programs
- Coordinate care such as lab work and preventive screenings
- Improve communication among all healthcare providers
Results of this collaboration are very encouraging, as the collaboration is helping improve the care these patients receive while reducing costs.