Cigna is more than halfway to its goal of having 100 collaborative accountable care (CAC) initiatives with healthcare providers by next year. The insurer announced seven additions to its roster as of April 1.
1. HealthCare Partners Medical Group (CA)
2. Greater Baltimore Health Alliance (MD)
3. Meritas Health (MO)
4. Atlantic Accountable Care Organization (NJ)
5. Novant Health (NC and SC)
6. Cleveland Clinic (OH)
7. Northwest Physicians Network (WA)
With the newest healthcare organizations on board, Cigna now has 58 CAC programs in 24 states covering more than 650,000 patients. Its goal is to serve 1 million patients by next year.
Cigna's CAC with Northwest Physicians Network is the health insurer's first in the state of Washington. The network is an independent physician association that includes 500 providers, 150 are primary care physicians; a "substantial primary care component" is a must-have to partner with Cigna in a CAC arrangement.
NPN is in three other collaborative care agreements with insurers. Two are active contracts, including the one with Cigna. Two others are waiting for approval from the state insurance commissioner: Aetna and Regence BlueShield. NPN is also a strategic partner with Franciscan Health System. The two organizations started a joint venture ACO this year with a contract from the Centers for Medicare & Medicaid Services.
Patricia Briggs, CEO of NPN says it has been collaborating and coordinating care for patients since it incorporated in 1995. While each collaborative care arrangement has positive aspects, Briggs says she is excited about the partnership with Cigna because the insurer is proactively promoting the new CAC.
"Cigna is doing a good job of informing [and] getting their members involved right at the beginning," says Briggs.
Cigna is promoting the arrangement by highlighting NPN as a "high quality provider of care" in its provider directories. Mary O'Neill, MD, Cigna's senior medical director for Washington says it is also reaching out to its group members.
"We have increasingly been asked by employers to feature the most effective members of our network. Some of them are even willing to affect their benefit structure around this," says O'Neill. "Some of them have been inviting people to come by during open enrollment or a health fair to talk about how their healthcare management model would work for individual employees and their dependents."
The arrangement between NPN and Cigna will cover more than 3,000 patients. As with the other CAC arrangements, the clinical care coordinators, who are RNs at NPN, will be key to helping patients navigate the arrangement and as well as achieving the triple aim of improved health, affordability, and patient experience.
NPN will receive incentive payments for meeting quality improvement topics, which include increased screenings and reduced hospital stays, and also lowering medical costs through coordinated care.
O'Neill says it is also giving some financial payment "out of the gate" to help offset the costs of the clinical care coordinators. The incentive payment for meeting quality and cost targets is issued yearly, unless the targets are not met, and in that case, the coordinated care payment remains does not go up.
Under the CAC, NPN patients who are Cigna members will have automatic access the program. Cigna says there are no changes in members' plans, though the patients most likely to see the first benefits of the agreement are those with chronic conditions, such as diabetes or heart disease.
Cigna, like other payers and health systems, is turning to accountable care partnerships to reduce costs and improve outcomes. The insurer's first venture into this arena began with a patient-centered medical home pilot project with Dartmouth-Hitchcock Clinic in 2008.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.