Cigna Accountable Care Program - New Haven Community Medical Group

In October 2012, Cigna and the New Haven Community Medical Group, launched an accountable care organization (ACO) pilot program to expand patient access to health care, improve care coordination, and achieve the “triple aim” of improved health outcomes (quality), cost effective care and increased patient satisfaction. The program will benefit nearly 18,000 individuals covered by a Cigna health plan who receive care from among New Haven Community Medical Group’s 583 physicians, including 216 primary care doctors and 367 specialists. The New Haven Community Medical Group is an integrated network of physicians and other health care professionals that works in clinical collaboration with the Yale-New Haven Hospital.  Under the program, New Haven Community Medical Group doctors monitor and coordinate many aspects of an individual’s medical care. Patients will continue to go to their current physician and automatically receive benefits of the pilot program.  The program is expected to provide immediate benefits for those who need help managing chronic conditions such as diabetes or heart disease. 

Critical to the program’s benefits are care coordinators, employed by the medical group, who 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 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 programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.