Cigna has expanded its accountable care organization (ACO) program with the creation of 10 new initiatives in seven states, bringing its total to 22 collaborative programs in 13 states that cover about 270,000 customers.
"Our existing programs are making excellent progress, so we're more convinced than ever that Cigna's collaborative approach to accountable care is the right model for how healthcare should be practiced in the U.S.," said Cigna Chief Medical Officer Alan Muney.
Under Cigna's ACO programs, which it calls "collaborative accountable care," the insurer partners with various physician practices to improve quality, affordability and patient satisfaction, focusing particularly on patients with chronic conditions such as diabetes and heart disease. Key to this arrangement is a registered nurse, hired by the doctor groups, who acts as a clinical care coordinator, helping patients with hospital follow ups, medication adherence and health screenings, for example, reported the Hartford Courant.
These patient coordinators also share claims data between Cigna and the physician groups so that participating doctors have a complete picture of the care they provide. "Payers have traditionally never shared any claims data with providers," Grace Terrell, president and CEO of Cornerstone, one of the physician groups selected to participate in the ACO program, told The Business Journal. "It's a model that's sort of based upon a different way of contracting than we've had before."
If the physician practices meet certain clinical and financial benchmarks, Cigna provides pay-for-performance rewards. To help avoid unnecessary procedures and limit escalating costs, Cigna is rewarding doctors for managing their patients, instead of simply providing a period checkup, Charlie Pitts, Cigna president and general manager for the Carolinas, told Triangle Business Journal.