Cigna and Central and Western Maine Regional PHO, a physician hospital organization in Lewiston, Farmington and other central Maine towns that’s affiliated with Central Maine Health and Franklin Community Health Network, 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, 2013.
Under the program, Central and Western Maine Regional PHO 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 the physician groups for the medical and care coordination services they provides. Additionally, they may be rewarded through a “pay for value” structure if it meets or surpasses targets for improving quality and lowering medical costs.
