Cigna Collaborative Accountable Care - Dartmouth Hitchcock

Program Location: 
Concord, NH
Number of Practices: 
Payer Type: 

Reported Outcomes


Cigna's Collaborative Accountable Care - Darthmouth Hitchcock program focused on individuals who received care from Dartmouth-Hitchcock primary care physicians practicing in family medicine, internal medicine and pediatrics. In the pilot, patients, especially those with chronic illness or ongoing medical needs, had access to enhanced care coordination, communications, appointment availability and education to help them navigate their health care system, while physicians received additional reimbursement for providing these enhanced services and supportive infrastructure. 

CIGNA and Dartmouth-Hitchcock (D-H) launched a Patient-Centered Medical Home pilot program in June 2008, with the goal of improving the quality, affordability and patient satisfaction with care through collaboration and aligned incentives. The program has three key components: clinical information; clinical collaboration; and a blended payment model. Along with a member roster, CIGNA provides D-H with lists of identified high-risk patients according to mutually agreed upon criteria. D-H provides "embedded case management services" i.e. a nurse who helps to coordinate the care of the patient with the goal of improving quality and reducing avoidable ER visits and hospitalizations for this high risk group & others identified. CIGNA also provides D-H with electronic feeds of "gaps in care", where identified issues such as medication compliance or needed preventive health care can be addressed at the time of the patient's next visit. Clinical collaboration between CIGNA and D-H encourages patient access to key programs.

Payment Model: 

Primary care providers affiliated with Dartmouth-Hitchcock will be paid for the medical services they provide, reimbursed an additional amount for enhanced services such as care management they provide and be rewarded through a “pay for performance” structure for improving quality and appropriate health care.

Cost Savings: 

Compared with expected costs, Dartmouth-Hitchcock achieved performance improvements in per patient, per month costs of $1.78

Last updated July 2014
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