Alliance Members Cigna and Kaiser Permanente Washington Recognized for Innovative Practices
The National Alliance of Healthcare Purchaser Coalitions (National Alliance) presented its eValue8™ Innovation Awards to two Washington state health plans, Cigna and Kaiser Permanente Washington (KP WA), for programs that use innovative approaches to deliver high quality health care. Both winners focused on helping patients access resources that were not directly related to health care, but affected their health and well-being.
Cigna was honored for its Distress Screening for Whole-Person Health program, a tool to support oncology patients. Cigna Clinical Program Senior Advisor Alysia Swanson, RN, BSOM, CCM, says Cigna realized the need for a quick and easy tool to assess the level of distress in cancer patients. Cigna’s distress thermometer includes five domains—physical, family, emotional, practical and spiritual/religious, using a scale from 0 (no distress) to 10 (severe distress). Based on the severity of the distress and/or problems identified, the case manager can connect the patient with support resources and collaborate with treating providers on case management interventions and recommendations. Swanson says “Cigna found customers often needed help getting food on the table or paying their utilities or medical bills. Case managers connected customers with helpful services such as even transportation assistance, connected them to community support programs and also behavioral health programs.”
Cigna’s National Medical Director Bhuvana Sagar, MD, says research shows Cigna’s distress screening provided considerable support to patients. “Screened customers were 16% more likely to be referred to internal and external sources than customers who were not screened with the tool.” Those who were screened were twice as likely to achieve their case management goals, engaged an average of 73 days longer, and were six times more likely to obtain behavioral health support. There were also considerable cost savings. One year after implementation, Sagar says “there was a $6,840 per member per year reduction in inpatient costs, an average decrease of 14.7% fewer inpatient visits, a 10.4% reduction in the number of customers likely to have more than one inpatient visit.”
KP WA was honored for its Community Resource Specialist (CRS) role, an integrated position within primary care offices designed to connect patients with resources to address their psychosocial needs. This role was originally created through funding by the Patient-Centered Outcomes Research Institute in 2014 to 2016 to provide patients with information, connection, and referral to social services as well as coaching around systems navigation and self-efficacy skills. KP WA Community Resource Program Manager Cindee DeWitt says the CSR commonly helps patients with needs such as “food, housing, transportation, caregiving support, and employment.” Currently, CRSs are part of KP WA’s standard staffing model for all primary care and two oncology departments. DeWitt says 26 CSRs work in 30 medical centers, with each CSR responsible for approximately 2,000 unique patients per month and approximately 3,300 patient encounters.
A 2019 survey of 1,159 KP WA members found:
- the CRS is valued by members and the care team and reflects well on KP WA, setting it apart from others in the market;
- members who had two or more CRS encounters reported positive changes and were very satisfied with the CRS, but members may need more than one encounter to benefit; and
- members have many unmet social needs the CRS can help address, but one unexpected and important benefit is help overcoming the barriers to accessing resources and the related stigma of asking for help.
Generally, DeWitt says the CRS contributed to improving patients’ overall health and well-being, decreasing financial stress, improving mental health, increasing their ability to fulfill care plans and access their care, and increasing satisfaction.
A total of six finalists were in the running for the Innovation Awards, including two others from Washington state; Aetna for its kidney support program and Premera Blue Cross for its partnership with telehealth addiction treatment provider Boulder Care.
The winners and runner ups presented their programs at a recent National Alliance webinar.
Published: December 1, 2021