Cigna Accountable Care Program - Physician Health Partners ACO

Program Location: 
Denver, CO
Payer Type: 
Commercial
Payers: 
Cigna
Description: 

Cigna and Physician Health Partners launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective January 1, 2014 and includes Denver-area doctors affiliated with Primary Physician Partners  and South Metro Primary Care .

Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit over 27,000 individuals covered by a Cigna health plan who receive care from among over 300 primary care physicians affiliated with the two medical groups.

Under the program, doctors with Primary Physician Partners and South Metro Primary Care 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 one of the medical groups 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.

Payment Model: 

Cigna will compensate Physician Health Partners 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

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