Cigna Collaborative Accountable Care Program - Novant Health

Program Location: 
Winston-Salem, NC
Payer Type: 
Commercial
Payers: 
Cigna
Description: 

Under the program, Novant Health monitors and coordinates all aspects of an individual's medical care. Patients continue to go to their current physician and automatically receive the benefits of the program. In addition, many patients using Novant Medical Group physicians will be managed using the EPIC electronic medical record system installed in practices, as well as have access to My Chart, an electronic patient access tool that enables patients to communicate with their care team and review medical records online.  

Critical to the program's benefits are registered nurses, employed by Novant Health, 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 medical group and Cigna that ultimately results in a better experience for the individual.  The care coordinators will enhance care by using patient-specific data from Cigna to help 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, identifies potential complications related to medications and helps prevent chronic conditions from worsening.  Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical support 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.

Payment Model: 

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

Last updated April 2014
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