16-07-2012 21:25 - Standing with Nancy Pelosi for health care, and voting to raise energy costs, Shelley Berkley is in the wrong corner for small business and Nevada taxpayers. Sign the petition for policies that will support small businesses and lower costs for Nevada -

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Shelley Berkley, In the Wrong Corner for Small Businesses in Nevada - Video

BLOOMFIELD, Conn. & DENVER--(BUSINESS WIRE)--

Cigna (CI) and New West Physicians, P.C., a large physician group in Denver, have launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the triple aim of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs.

Accountable care is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs.

The number one priority of our physicians is to help our patients stay healthy so they can live their lives to their full potential, said Ruth Benton, chief executive officer at New West Physicians. This collaboration with Cigna is an opportunity to achieve the triple aim while delivering well-coordinated patient care that results in health improvement.

The program will benefit nearly 7,800 individuals covered by a Cigna health plan who receive care from among approximately 60 primary care physicians and 20 mid-level providers in 16 locations throughout the Denver Metro area. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a New West physician will also have access to the benefits of the program.

New West Physicians will monitor and coordinate all aspects of an individuals medical care. Patients will continue to go to their current physician and will not need to take any action to receive the benefits of the program. There also are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease.

Cigna is committed to supporting New West Physicians efforts to put the patient at the center of its practice, with expanded access to care, better coordination of care, patient education about chronic conditions and wellness, and access to clinical programs for health improvement, said Mark Laitos, M.D., Cigna's senior medical director for Colorado. This is an important step toward creating a health care system that rewards physicians for the quality of care they provide rather than the number of procedures they perform.

Critical to the programs benefits are registered nurses, employed by New West Physicians, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators enhance care by using patient-specific data provided by Cigna to identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators contact these individuals to help them get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.

The care coordinators also help patients schedule appointments, provide health education and refer patients to Cigna's clinical programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.

Cigna will compensate New West Physicians for the medical and care coordination services it provides. Additionally, the practice may be rewarded through a pay for performance structure if it meets targets for improving quality and lowering medical costs.

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New West Physicians, P.C. and Cigna Bring Accountable Care to Denver

By Lee Samaha - July 17, 2012 | Tickers: ABT, COV, ISRG, JNJ | 0 Comments

Lee is a member of The Motley Fool Blog Network -- entries represent the personal opinions of our bloggers and are not formally edited.

Investors have been keen to bid up defensive sectors recently but one stock seems to have been left behind in the rush. Tyco spinoff Covidien (NYSE: COV) appears to be unloved by the market, yet its mix of stable single digit revenue growth plus double digit earnings growth and high cash flow generation is quite compelling.

Moreover, the future spinoff of its low growth pharmaceuticals division will allow the management to fully focus on medical devices. Reductions in headcount and facilities over the last few years have generated operational efficiencies that have led to margin improvement. This company is well run, it trades at a discount to its peers and I think it's well worth a look for risk adverse investors.

Covidien Offers a Mixed Growth Opportunity

In this article I am going to focus on medical devices. A graphic depiction of Covidiens offerings by product line reveals the mixed performance over the last few years.

Whilst Soft Tissue Repair and Airway & Ventilation growth has been hard to come by, Vascular and in particular Energy growth has been strong. Oximetry & Monitoring and Endomechanical growth has slowed this year. The company is currently tracking ahead of its internal 2-5% overall growth for medical devices but it has been clear in articulating that headwinds would get stronger in the second half. In addition there is one less trading week this year.

Endomechanical and Energy Products are Driving Growth

Together these product lines make up 46.8% of medical device sales, and Energy has consistently generated double digit revenue returns in recent years. Endomechanical and Energy devices in surgical procedures are increasingly being used in a drive to shift surgical procedures from open toward minimally invasive surgery (MIS). The big advantage of MIS is that it tends to lead to better patient outcomes, which in turn creates shorter hospital stays and less post-surgery complications. Both of which reduce hospital costs.

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An Undervalued Health Care Stock

CHICAGO, July 17, 2012 /PRNewswire/ -- Long term care liability loss rates and claim severity reached an eight-year high and are expected to grow steadily in 2013 against a backdrop of health care provider budget constraints and uncertainty about health care reform, according to Aon Risk Solutions, the global risk management business of Aon plc (AON). This finding is illustrated in the 2012 Aon Long Term Care General Liability and Professional Liability Actuarial Analysis, released July 12 in partnership with the American Health Care Association.

(Photo:http://photos.prnewswire.com/prnh/20120717/CG41708-INFO )

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Since 2005, the annual loss rate (liability costs relative to occupied long term care beds) has grown from $1,040 to a projected $1,480 in 2012 and is expected to increase again in 2013 to $1,540, according to the report based on 19,500 individual claims from long term care facilities. Claim severity (claim size) also has grown from a low of $109,000 per claim in 2005 to a projected $168,000 per claim in 2012 and $175,000 in 2013. Claim severity and loss rates have been growing consistently since 2009 at a rate of 4 percent annually, even though claim frequency has been stable since 2008.

"Long term care and skilled nursing centers strive to provide quality care each day, but they also must find ways to cope with the ever-increasing cost of doing business and multiple rounds of funding reductions at the state and federal level. This report underscores the need to continue to utilize tools like voluntary arbitration agreements, a cost-effective option for long term care providers and their residents to resolve legal disputes," said Governor Mark Parkinson, president and CEO of AHCA/NCAL.

Liability and the Long Term Care Profession Long term care providers faced high loss rates in the late 1990s and early 2000s. Over the years, they answered this challenge by reinvesting in patient safety, developing liability defenses, advocating for limits on tort damages and implementing arbitration. While these efforts helped providers control the growth of liability costs, reductions in Medicare reimbursement rates and health care reform have had an impact on long term care provider revenue and budgets.

"With reduced revenue, providers may have difficulties funding expansion and improvements, maintaining facilities and hiring and training qualified caregivers," said Christian Coleianne, associate director and actuary at Aon Global Risk Consulting. "These competing priorities have the potential to impact liability costs. By providing access to this invaluable data, we are enhancing our clients' ability to better understand and more effectively manage these risks."

The Patient Protection and Affordable Care Act encourages closer coordination of care with additional health care providers with the expectation of reduced costs. Interaction between long term care providers and dependence on other health care providers may increase exposure as the new system is expected to operate at a lower cost.

Loss Rates by State State laws and the state judiciary have a tremendous influence on liability costs. As a result, state loss rates vary considerably. For example, tort limits on awards are constitutionally prohibited in Kentucky, which has the highest loss rate in this study ($5,120 per bed for 2012). In contrast, Texas amended its constitution to protect its tort limits and has the lowest projected loss rate ($320 per bed for 2012).

"Malpractice costs and the tort environment are often major considerations in the decision to locate and invest in long term care beds and services in a specific state," said Dom Colaizzo, chairman of the National Health Care Practice for Aon Risk Solutions. "This ultimately affects the supply of beds and cost to seniors and their families in a marketplace where demand is growing for senior care and constrained by reduced reimbursements."

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Aon forecasts eight-year high for long term care liability loss rates, claim severity

For Gov. Rick Perry, saying "no" to the federal health care law could also mean turning away up to 1.3 million Texans, nearly half the uninsured people who could be newly eligible for coverage in his state.

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States saying no to 'Obamacare' could see downside