The move by these payers to vertically integrate home-based care delivery allows them to "gain reputational benefits from delivering these services and to avoid the double marginalization that occurs when these services are purchased from an outside firm," says Adam Powell, a healthcare economist and president of Payer+Provider Syndicate in Boston.
"As Cigna, Humana, and WellPoint have all made acquisitions in this space, offering convenient chronic care management services may soon become table stakes."
Morris says Cigna looked at several care models before deciding on the Alegis Care approach, which puts the primary care physician in the driver's seat in caring for this population with support from social workers, nurse practitioners, pharmacists, and other healthcare providers. Morris says it is the right model to improve healthcare quality as well as the patient experience.
"If we can improve those two, we think the cost comes down," says Morris.
It is also easier to scale than the CareMore model, which requires bricks and mortar facilities.
Morris said Cigna has plans to expand its geographic reach, and grow the risk assessment and chronic care components of Alegis Care, as well as its third party business.
Risk assessment is particularly important in the care of this frail population, especially among new Medicaid or Medicare members. Morris says performing a thorough exam within the first 120 days of membership is critical in terms of quantifying co-morbidities in order to develop a care plan for the member.