Cigna launched a collaborative accountable care initiative with Martin's Pointh Health Care (a primary care medical practice in Bangor, Portland and other Maine communities, plus Portsmouth, N.H.) and Mercy Health System (a comprehensive health care delivery organization with locations throughout greater Portland) 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 in 2012.
Under the program, the ACOs 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 organizations for the medical and care coordination services they provide. Additionally, they may be rewarded through a “pay for value” structure if they meets or surpasses targets for improving quality and lowering medical costs.
