Cigna Collaborative Accountable Care - Core Physicians

Program Location: 
Exeter, NH
Payer Type: 
Commercial
Payers: 
Cigna
Description: 

Cigna and Core Physicians 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 January 1, 2014 and is Cigna's fourth accountable care initiative in New Hampshire. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit nearly 4,000 individuals covered by a Cigna health plan who receive care from more than 120 Core Physicians primary care doctors and specialists.

Under the program, Core Physicians 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 Core Physicians 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.

Critical to the program’s benefits are the clinical care coordinator and practice-based registered nurses, employed by Core Physicians, who will help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the medical group and Cigna, which will ultimately provide a better experience for the individual.

Payment Model: 

Cigna will compensate Core Physicians for the medical and care coordination services its participating organizations provide. Additionally, the organizations may be rewarded through a “pay for performance” structure if they meet their 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 April 2014
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