Cigna Collaborative Care Program - St. Joseph Health System

Program Location: 
Bryan, TX
Payer Type: 
Commercial
Payers: 
Cigna
Description: 

Cigna and St. Joseph Health System  have a collaborative care initiative to improve patient access to health care, enhance care coordination, and achieve the goal of improved health,affordability and patient experience. The program became effective July 1 and is Cigna's first collaborative care initiative serving the Brazos Valley. Cigna currently has eleven collaborative care arrangements throughout Texas and 100 of them nationwide.

Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit approximately 4,000 individuals covered by a Cigna health plan who receive care from approximately 265 primary care doctors and specialists with St. Joseph in the Brazos Valley.

Under the program, St. Joseph Health System doctors 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 doctor with St. Joseph Health System 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 registered nurse clinical care coordinators, employed by St. Joseph Health System, 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 St. Joseph Health System for the medical and care coordination services doctors provide. Additionally, St. Joseph may be rewarded through a “pay for value” structure for meeting targets for improving quality and lowering medical costs.

Last updated July 2014
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