Cigna Plans Aggressive Expansion for ACO-like Program

CAC contracts include Palo Alto Medical Foundation (California), New West Physicians Group (Denver), Mount Carmel Health Partners (Columbus, Ohio), and Dartmouth-Hitchcock Clinic (New Hampshire), and Medical Clinic of North Texas (Dallas-Fort Worth).

The aggressive expansion schedule reflects competition?Aetna is also committed to a nationwide ACO network as well as the promising results delivered by Cigna's CACs so far.

The physician-focused CAC model involves large primary care or multispecialty physician groups, and independent physician associations, as well as some integrated delivery systems (IDS) and physician-hospital organizations (PHO). Even when an IDS or PHO is involved in a CAC, the physician is still the focus because "physicians hold the power of the order pen," Salmon says.

Participating physician groups each have at least 10,000 Cigna members in their practice. Salmon explains that measuring total medical costs and quality parameters is difficult and can be unreliable for smaller populations.