Cigna Collaborative Accountable Care - Summit Medical Group

Program Location: 
Berkeley Heights, NJ
Payer Type: 
Commercial
Payers: 
Cigna
Description: 

The joint program benefits approximately 10,000 individuals covered by a Cigna health plan who receive care from more than 300 Summit Medical Group providers. 

Through its electronic health record, Summit Medical Group doctors monitor and coordinate all aspects of an individual’s medical care. In this arrangement with Cigna, patients will continue to go to their current SMG physician and automatically receive the benefits of the program. There also are no changes in any plan requirements regarding referrals to specialists. While all patients will benefit from this initiative, patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease.

Using patient-specific data from Cigna and from Summit Medical Group's electronic health record, care coordinators identify patients discharged from the hospital who might be at-risk for readmission, as well as patients who may be overdue for important health screenings or who may have a medication-related issue. Part of Summit Medical Group's physician-led team, care coordinators help patients get the follow-up care or screenings they need. The care coordinators are aligned to a team of Cigna case managers to ensure a high degree of collaboration between Summit Medical Group and Cigna that ultimately results in a better experience for the individual.  Care coordinators can also help patients schedule appointments, provide health education and inform patients about SMG's clinical programs (Freedom from Smoking Program, weight management, Behavioral Health Program, or the Diabetes Live Well Program) as well as Cigna's health, wellness and chronic condition management programs available to them through their employer's health plan.

Payment Model: 

Cigna will compensate Summit Medical Group physicians for the medical and care coordination services they provide. Additionally, SMG physicians may be rewarded through a “pay for performance” structure if they meet targets for improving quality and lowering medical costs.

Last updated Giugno 2014
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