If you're new to Cigna or changing plans and your provider is outside your new Cigna plan's network, or if you are a current customer and your provider is leaving your plan's network, Transition or Continuity of Care may allow you to see them for a defined amount of time if you have certain medical conditions. What is Transition of Care? With Transition of Care, you may be able to continue to receive services for specified medical and behavioral conditions with health care providers who are not in your plan's network at in-network coverage levels. This care is for a defined period of time until the safe transfer of care to an in-network doctor or facility can be arranged. You must apply for Transition of Care at enrollment, or when there is a change in your Cigna medical plan. You must apply no later than 30 days after the effective date of your coverage. What is Continuity of Care? With Continuity of Care, you may be able to receive services at in-network coverage levels for specified medical and behavioral conditions when your health care provider leaves your plan's network.
04/21/2011 ^ Patient-Centered Care ^ Please visit for additional information. ^ "Transition Coaches Reduce Readmissions for Medicare Patients With Complex Postdischarge Needs". Agency for Healthcare Research and Quality. 2013-04-10. Retrieved 2013-05-10. CS1 maint: discouraged parameter ( link) ^ Stern, D. T. ; Caldicott, C. V. (1999). "Turfing". Journal of General Internal Medicine. 14 (4): 243–248. 1525-1497. 1999. 00325. PMC 1496571. PMID 10203637. ^ Doctors Admit to Unprofessional Behavior in Study at 3 Chicago Hospitals. By Jordan Rau. From Kaiser Health News, June 2012
Continuity of Care Improves Treatments across Disciplines Continuity of care produces varying positive outcomes among different health disciplines. For instance, among preventative medicine and general health practitioners, continuity of care results in improved appointment follow-through, hypertension outcomes, identification of bacterial meningitis, and prescription compliance. One prime example of positive outcomes within health varying disciplines can be noted with maternity midwife practitioners. Fewer consumers are developing high blood pressure during pregnancy, a serious condition called preeclampsia, and less maternity patients feel the need to request painkillers during labor. Consumers experience increased trust, rapport, and confidence with behavioral health specialists, and among asthma specialists, patients feel enhanced emotional and mental health. Studies such as those conducted by the CMS have proven that continuity of care leads to enhanced quality of care and improves outcomes across many disciplines.
Adverse patient outcomes include continuation or recurrence of symptoms, temporary or permanent disability and death. Healthcare utilization outcomes for patients experiencing poor transitional care include returning to the emergency room or being readmitted to the hospital. As healthcare expenditures rise at an unsustainable rate there is increasing focus by patients, providers and policymakers on restraining unnecessary resource utilization such as that incurred by preventable re-hospitalizations. Transitional care or transition care also refers to the transition of young people with chronic conditions to adult based services. Transition care is a Youth Health service. As children mature into young adults, they outgrow the expertise of children's services (paediatrics) and need to find an adult health service that suits them. A program in Australia GMCT Transition Care is an initiative aimed at improving continuity of care for young people with chronic health as they move from children's (paediatric) to adult health services.
Technology has a big role to play in making that happen. An example is the new personal health record that will eventually be available on that will help Albertans be partners in their continuity of care. When done well, all care providers talk to each other effectively and the information is captured in one place, where all can access it. This helps towards high quality care over time that is also cost-effective, sustainable, and most importantly patient-centred. Increasing the role of the patient in managing their health and healthcare records is a vital part of the future of continuity in healthcare. Tagged as Featured, Latest, About the Future of Health How do we co-design and co-deliver a sustainable, quality health system that promotes healthy communities and provides access to services, programs and facilities? The first step is by working together - Alberta Health Services, Alberta Health, community health partners, and all Albertans.