Cigna Collaborative Accountable Care - NYUPN Clinically Integrated Network, LLC

Program Location: 
New York, NY
Payer Type: 

Under the program, NYUPN monitors and coordinates all aspects of an individual's medical care, both in and out of the hospital. Individuals most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease. Cigna customers whose physician is in the NYUPN will automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and choose to seek care from an NYUPN doctor can also access the program. There are no changes in plan requirements regarding referrals to specialists.  Critical to the program's benefits are NYU Langone Medical Center employed registered nurses who serve as embedded care coordinators and 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 NYUPN and Cigna, providing a better experience for the individual. They are part of a physician-led care team that helps patients get the primary and specialty care they need, identifies potential complications related to medications, and manages chronic conditions to improve outcomes and reduce costs.

The care coordinators use patient-specific data from Cigna to identify patients discharged from the hospital who may be at risk for readmission, as well as those who may be overdue for important health screenings or may need help managing their medications.  Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.

Payment Model: 

Cigna will compensate  NYUPN Clinically Integrated Network, LLC 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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