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Cigna Plans Aggressive Expansion for ACO-like Program

Margaret Dick Tocknell, for HealthLeaders Media, August 9, 2012

Cigna is doubling down on its commercial ACO strategy.

The insurer has accelerated the development of its collaborative accountable care (CAC) program. The CAC is Cigna's variation on the accountable care organizations (ACO) created as part of federal healthcare reform.

While ACOs focus on physicians and hospitals providing coordinated care to improve quality and lower the cost of care for Medicare beneficiaries, Cigna's version of the comercial ACO is an insurer-physician partnership that provides coordinated care to improve quality and contain healthcare costs across Cigna's commercial and Medicare Advantage books of business.

Leavitt Partners, a Salt Lake City–based health intelligence business estimates that there are currently nearly 200 commercial ACOs or ACO-like organizations at some stage of development. Aetna is one of them. Blue Shield of California is another.

Like Cigna’s efforts, Aetna’s ACO program is in its infancy but has plans for significant growth. It has 10 ACO agreements in place and expects to have 20 under contract by the end of 2012. It plans to develop a national ACO network over the next five years.

Cigna has fashioned the original ACO concept into a model that enables the insurer to use its extensive member database in a more formal care management relationship with selected physician partners.

The Connecticut-based insurer added 20 CACs this year, including 10 in July alone. Cigna now has 32 CACs covering 300,000 members in place in 16 states. Its goal is to have 100 CACs serving one million members in place across the United States by 2014, says Dick Salmon, MD, Cigna's national medical director for performance measures and improvement.

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