Cigna (NYSE: CI) and Beacon Health , a subsidiary of EMHS (Eastern Maine Healthcare Systems), have launched a collaborative accountable care initiative to improve patient accessto health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective January 1, 2014.
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit the nearly 7,000 individuals covered by a Cigna health plan who receive care from Beacon Health’s 600 primary care doctors and specialists.
Under the program, Beacon Health will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to be treated by 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, heart disease and obesity.
Cigna will compensate Beacon Health for the medical and care coordination services it provides. Additionally, Beacon Health may be rewarded through a “pay for value” structure if it meets or surpasses targets for improving quality and lowering medical costs.
