Cigna Accountable Care Program - Boulder Community Hospital Community Medical Associates

Program Location: 
Boulder, CO
Payer Type: 
Commercial
Payers: 
Cigna
Description: 

Cigna and doctors affiliated with Boulder Community Hospital’s Community Medical Associates  have launched 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. The program will benefit approximately 4,500 individuals covered by a Cigna health plan who receive care from among over 80 Community Medical Associates primary care physicians and specialists.

Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The new program is the latest in its efforts to collaborate with physicians in Colorado to focus on prevention, care coordination and value. Nearly 45,000 Cigna customers in Colorado now have a physician practice whose doctors take part in one of six joint collaborative accountable care programs Cigna has in the state.

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 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.

Payment Model: 

Cigna will compensate Boulder Community Medical Associates 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.

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