Cigna Enters Collaborative Care Program to Lower Costs

Cigna and Integrated Independent Physicians Network, LLC have entered into a collaborative care program to improve access to healthcare, enhance care coordination and lower costs. The program became effective April 1 and will reach nearly 7,000 customers, according to a press release from Cigna.

The program is part of Cigna Collaborative Care, a value-based model that aims to improve patient access to healthcare, enhance care coordination, and achieve the same population health goals as accountable care organizations (ACOs): improved health, affordability and patient experience.

In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. For example, the programs are helping to:

  • Close gaps in care, such as missed health screenings or prescription refills
  • Reinforce the appropriate use of hospital emergency rooms
  • Increase the number of preventive health visits
  • Improve follow-up care for people transitioning from the hospital to home

“This program gives us valuable data and insights that can help integrate our approach to patient care,” said Dr. George White, president of the IP Network. “When physicians and health insurers are on the same team, real health improvement occurs.”

[pullquote]”Through these types of collaborations we have the opportunity to help transform the healthcare delivery system and offer improved quality and affordability to our customers,” said Michael Howell, M.D., Cigna’s senior medical director for Florida. “Transitioning to a value-based reimbursement model rewards doctors for results and focuses on prevention, wellness, health improvement and care coordination.”[/pullquote]

Critical to the program’s benefits are registered nurse clinical care coordinators, employed by the IP Network, who will help patients with chronic conditions or other health challenges navigate the healthcare system.

The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the physician group and Cigna, which will ultimately provide a better experience for the individual. The care coordinators are part of physician-led care teams that will help people get the follow-up care or screenings they need, identify potential complications related to medications and help prevent chronic conditions from worsening.

They can also help individuals schedule appointments, provide health education and refer people to Cigna’s clinical support programs that are available through their employer’s health plan.

Cigna will compensate the IP Network for the medical and care coordination services it provides. Additionally, the group may be rewarded through a “pay for value” structure if it meets targets for improving quality and lowering medical costs.

Cigna  now has 150 Cigna Collaborative Care arrangements with large physician groups. They span 29 states, reach 1.7 million commercial customers and encompass more than 69,000 doctors, including nearly 34,000 primary care physicians and nearly 36,000 specialists.

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