Cigna and Valley Preferred are launching acollaborative 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, Cigna's first collaborative accountable care initiative to launch in Pennsylvania, was effective July 1, 2013. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs. The program will benefit approximately 5,500 individuals covered by a Cigna health plan who receive care from Valley Preferred primary care and specialty physicians.
Under the program, Valley Preferred physicians monitor and coordinate all aspects of an individual’s medical care. Patients continue to go to 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 Valley Preferred physician 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 or heart disease.
Critical to the program’s benefits are Valley Preferred registered nurses who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the physician practice and Cigna that ultimately results in a better experience for the individual.
Cigna will compensate physicians for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a “pay for performance” structure if it meets targets for improving quality and lowering medical costs
