Cigna Collaborative Accountable Care (CAC) Program - Arizona Community Physicians and Arizona Connected Care

Program Location: 
Tuscon, AZ
Payer Type: 
Commercial
Partner Organizations: 
Arizona Community Physicians
Arizona Connected Care
Payers: 
Cigna
Description: 

In july 2013, Cigna and tow different Tucson-ara organizations - Arizona Community Physicians and Arizona Connected Care, luanched 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.  Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations (ACOs).  The programs will benefit approximately 12,000 individuals covered by a Cigna health plan who receive care from among approximately 119 health care professionals affiliated with Arizona Community Physicians or 217 health care professionals who are a part of Arizona Connected Care.   Under the program, doctors monitor and coordinate all aspects of an individual’s medical care. Patients continue to go to their current physician and automatically receive benefits of the program. 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.

Critical to the program's benefits are registered nurses, employed by the medical groups, who serve as clinical 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 the physician practices and Cigna that ultimately results in a better experience for the individual. The care coordinators will enhance care by using patient-specific data from Cigna to help identify patients being 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 skipped a prescription refill. The care coordinators are part of the physician-led care team that helps patients get the follow-up care or screenings they need, identifies potential complications related to medications and helps prevent chronic conditions from worsening. Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support programs that may be available as part of their employee benefits plan. Examples include disease management programs for diabetes, heart disease and other conditions, and lifestyle management programs for tobacco cessation, weight management and stress management.

Payment Model: 

Cigna will compensate the two physician organizations for the medical and care coordination services they provide. Additionally, they will be rewarded through a “pay for value” structure for meeting targets for improving quality and lowering medical costs.

Last updated April 2014
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