Amid the release of proposed rules covering accountable care organizations, Cigna (NYSE: CI) announced that quality is improving and costs are being reduced through its ACO pilots and, therefore, plans to more than double its pilot programs this year.
Cigna has seen positive results since 2007 at its own Cigna Medical Group of Arizona and since 2008 at Dartmouth-Hitchcock Medical Center. In Arizona, the ACO program resulted in annual savings of $336 per patient and the cost of ambulatory surgery is down 11 percent. The number of preventive care visits rose by 3 percent overall, including an increase of 12 percent for adults, reports the Hartford Courant. Additionally, there was a 10 percent improvement in closing gaps in care because a care coordinator made sure patients followed through on appointments and medical tests.
"In essence, what we do is we set quality targets and cost targets," Jeffrey Kang, Cigna's chief medical officer, told the Courant. "And if they beat the quality targets, then we look to see how they do against the cost targets, and if they beat the cost targets, we share some of those savings back with them. The key here is you must improve quality in order to be eligible for any of the savings."
While there has been much focus over the past year on the ACO concept, Cigna's model is slightly different than the traditional program. "Our model of collaborative care is an ACO that's built on patient-centered medical home principles and a heavy emphasis on collaboration and communication. Cigna physicians and nurses have frequent contact with doctors and nurses at the physician practices to help with coordination of patient care," says Dick Salmon, Cigna's national medical director for performance measurement and improvement.
One of Cigna's goals is for physicians to see the clinical programs as an extension of their own practice and refer patients to 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's 12 current initiatives are in 11 states, involving 100,000 Cigna customers and 1,800 physicians. Programs include multi-payer pilots in Colorado, New Hampshire, Pennsylvania and Vermont and Cigna-only collaborative initiatives in Arizona, Connecticut, Georgia, Maine, Missouri, New Hampshire, Tennessee and Texas, according to Becker’s Hospital Review.