Two New Hampshire health care groups have announced recent expansions in the Granite State, one a Medicare-related effort that brings three hospitals into Dartmouth-Hitchcock umbrella, the other an expansion of a Cigna effort in the Exeter-Portsmouth areas.
Cigna said the expansion will bring an estimated 4,000 patients under its accountable care effort. Physicians and nurses affiliated with Exeter Hospital will oversee the care of Cigna patients, with an emphasis on management of chronic conditions such as diabetes, heart disease and obesity, Cigna said.
Meanwhile, Dartmouth-Hitchcock announced that Catholic Medical Center, St. Joseph Healthcare in Nashua and Exeter Health Resources had joined its Accountable Care Organization, bringing 46,700 Medicare primary-care patients, all from New Hampshire, under the Dartmouth-Hitchcock effort.
Pushed by the Affordable Care Act, ACOs attempt to lower costs by providing preventive, coordinated care to patients. Doctors and hospitals in the network are held to quality standards, including lowered hospital admissions and readmissions, patient monitoring and preventive health.
Savings in Medicare billings are shared with the providers.
Dartmouth Hitchcock said it also renamed and trademarked its ACO. It will not be called allwell.
"Health-care delivery will continue to evolve as health-care organizations adapt to health-care
reform. CMC's participation in the allwell ACO will enable us to better serve the needs of our
community as we look across the continuum of care," said Dr. Joseph Pepe, president and chief-executive of CMC, in prepared remarks.
CMC senior vice president Alex Walker said the hospital reviewed the move in light of Catholic health-care guidelines. All care will be consistent with those guildelines, he said.
CMC, St. Joseph and Exeter joined the ACO as of Jan. 1. Dartmouth-Hitchcock spokesman Rick Adams said patients in an ACO will be notified. They will keep their own doctor, but nurses will ensure a patient's care is coordinated among a patient's various providers.
The Cigna programs deal with employer-provided health care and are not part of the Affordable Care Act, said spokesman Mark Slitt. He said tens of thousands of Cigna patients in southern and central New Hampshire are enrolled in ACOs.
Patients will be able to keep their doctor and experience no change in their plan requirements for referrals, the company said.
"By paying more attention to the patient, with a stronger focus on prevention, wellness and care coordination, we'll have a healthier population and lower medical costs," said Dr. Robert Hockmuth, Cigna's senior medical executive for New Hampshire.