Cigna Accountable Care Organization - Santa Clara County IPA

Program Location: 
San Francisco, CA
Payer Type: 

Cigna and Santa Clara County IPA  (SCCIPA) have launched a collaborative accountable care  initiative to improve patient access to health care, enhance care coordination, and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective October 1, 2013 and is Cigna's third accountable care initiative in the Bay Area.

Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit more than 13,000 individuals covered by a Cigna PPO health plan who receive care from SCCIPA’s 850 primary care doctors and specialists.

Under the program, SCCIPA will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physician and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a SCCIPA doctor will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes, heart disease and obesity.

Payment Model: 

Cigna will compensate Santa Clara County IPA for the medical and care coordination services it provides. Additionally, the organization may be rewarded through a “pay for performance” structure if it meets its targets for improving quality and lowering medical costs. Employers who sponsor health plans will benefit from lower health care costs or health care costs that increase at lower rates.

Last updated June 2014
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