MANCHESTER — Granite Healthcare Network, a collaboration among five hospital systems, is partnering with Cigna Health Care on a new accountable care organization.

“It's really a great initiative for us,” Rachel Rowe, executive director of Granite Healthcare Network, said.

“It's the first time Granite Healthcare Network is entering into a partnership with an insurer to provide better health for communities, better care for patients and lower cost,” she said.

It also is the first time Cigna has partnered in an accountable care model with multiple organizations, spokesman Mark Slitt said.

Most prior agreements were with a primary care doctor's office, an integrated delivery system including doctors and facilities or a multi-speciality practice.

“This is a little bit of a twist,” he said.

Granite Healthcare Network is made up of Concord Hospital, Elliot Hospital, LRGHealthcare (Lakes Region General and Franklin Regional hospitals), Southern New Hampshire Health System (Southern New Hampshire Medical Center) and Wentworth-Douglass Hospital in Dover.

The hospitals are adopting analytical programs to improve care and reduce costs. Together, they cover nearly half the state's population.

An accountable care organization is a group of health care professionals that accepts responsibility to be held accountable for the population it serves. Cigna calls its model collaborative accountable care.

“Care coordination is well-known to provide better outcome so we're looking forward to the opportunity to work with Cigna on that;” Rowe said.

The model will use registered nurses who work for the hospitals to coordinate care and ensure patients don't miss appointments, prescription renewals or medical tests.

The program will target chronic conditions such as high blood pressure and diabetes to help patients manage them better.

“We're seeing it changing in terms of quality improvements from a clinical perspective,” Dr. Robert Hockmuth, Cigna's medical director for New England, said.

Hockmuth used to practice in the Monadnock Region as well as in Hopkinton.

“Ultimately, that translates into dollar savings,” Hockmuth said. For example, a patient with a chronic illness who is reminded to get a test that and then receives appropriate treatment that prevents a complication from developing and landing that person in the hospital can save costs.

“That's how it's connected,” Hockmuth said.

The hospitals will be rewarded with extra payments if they meet targets for improving quality and lowering costs.

“Cigna has been a leader in accountable care, both here in New Hampshire and throughout the country, which is why we chose Cigna as the health plan for this initiative,” Dr. Greg Baxter, chief medical officer for the Granite Health Network, said in a statement.

The program will benefit more than 23,000 individuals covered by a Cigna health plan who receive care from among more than 900 GHN-participating health care professionals.

Patients will continue to see their current physician and there are no changes in any plan requirements regarding referrals to specialists.

“We believe that a system that's focused on value rather than volume of care offers the best path to improved health and lower medical costs, which is good for individuals, families, employers and doctors,” Donald Curry, president for Cigna in New England, said in a statement.

Cigna's first accountable care program, both in the state and the country, was Dartmouth-Hitchcock. It produced a 10 percent improvement in the practice's overall closure rate for gaps in care compared to other Cigna-affiliated physician practices in the market where patient care isn't coordinated.

For high blood pressure (hypertension), Dartmouth-Hitchcock showed a 16 percent improvement compared to the market, and for diabetes an 8 percent improvement.

“We worked to co-develop reporting capabilities, some ways of doing outreach for patients and I think it's beeen a fabulous relationship,“ Dr. Barbara Walters, senior medical director for Dartmouth-Hitchcock's accountable care organization, or ACO, project, said.

The program started in June 2008.

On the Net: granitehealth.org. newsroom.cigna.com/KnowledgeCenter/ACO. Email: dpaiste@unionleader.com.