Under the program, Meritas Health physicians monitor and coordinate all aspects of an individual's medical care. Patients 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 in the medical group 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 or heart disease.
Cigna will compensate Meritas Health physicians for the medical and care coordination services they provide. Additionally, physicians will be rewarded through a “pay for value” structure if they meet targets for improving quality and lowering medical costs. Critical to the program’s benefits are Meritas Health nurses, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system.
