The goal of the Collaborative Accountable Care (CAC) program is to better coordinate care. Primary care and specialty care doctors will work together toward improved quality, better health outcomes and lower health care costs. Critical to the program's benefits are clinical care coordinators, including nurses, physicians, and other professionals, employed by Brown & Toland, who help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators will enhance care by using patient-specific data from both organizations to 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, identify any issues related to medications, and help prevent chronic conditions from worsening. Patients will also receive health education and will have access to both organizations' wellness and 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.
Cigna will compensate Brown and Toland Physicians 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.
"[Cigna's] outpatient success was a result of our strong partnerships with ancillary facilities as well as our providers’ commitment to decrease avoidable emergency room visits by providing easy access to primary care services."