Cigna and Fairfield County Doctors Form ACO - Analyst Blog
U.S. health insurer
) has started a Collaborative Accountable Care (CAC) initiative
with two Fairfield County physician groups named PriMed and
Greenwich Physicians Associations, Inc.
Approximately 12,000 customers of Cigna who are covered under the Cigna health plan, and receive care from PriMed and Greenwich Physicians' 200 affiliates, will stand to gain from the initiative, which is already in effect Jan 1, 2014 onwards.
This step by Cigna is in sync with the company's goal to improve the quality of care and service provided to customers, along with that of lowering healthcare costs and enhancing overall value.
Cigna's Collaborative Accountable Care initiative is similar to an Accountable Care Organization (ACO). An ACO is a group effort by healthcare providers, who voluntarily form alliances to provide coordinated high quality care for patients.
An ACO is accountable for the quality, cost and overall care offered to members. By focusing on the needs of patients and connecting payments to the service offered, this model intends to improve the health of individuals and communities besides curtailing rising healthcare costs.
Through the Collaborative Accountable Care program, doctors will monitor and coordinate all the aspects of patient care. Patients will receive the associated benefits even when they retain their current physician. The program does not specify any changes regarding referrals to specialists. Patients suffering from long-term diseases such as diabetes, heart disease and obesity are the ones who are poised to benefit the most from this initiative.
The enrollees in the program will also have the additional benefit of receiving the services of registered nurses. They will coordinate patient clinical care, educate patients about various health conditions and counsel them on proper healthcare needs.
The ACO will also designate care coordinators to work closely with patients and monitor the services being offered. They will follow up with the patients throughout, sending reminders about screenings required or recommend direct medical help. At the same time, they will educate patients by helping them to participate in various health and wellness programs and workshops.
The medical groups will be paid by Cigna on the basis of quality services rendered by them.
Initiatives like ACOs or the one adopted by Cigna, are being deployed to improve population health in general and to offer high quality healthcare to patients.
Cigna's initiative is based on a Patient-Centered Medical Home (PCMH) program. Through the PCMH, Cigna works to improve patient care with strong focus on collaboration and communication with physician practices.
At present, Cigna is engaged in 86 Collaborative Accountable Care initiatives in 27 U.S. states. These programs provide services to more than 880,000 Cigna customers. Cigna initiated its first CAC program back in 2008. Cigna aims to serve about 1 million customers via 100 CAC initiatives by 2014.
Companies like UnitedHealth Group Inc. ( UNH ) and Aetna Inc. ( AET ) are also active about ACO initiatives.
Cigna currently holds a Zacks Rank #2 (Buy). Another top-ranked stock, Kemper Corporation ( KMPR ) carrying a Zacks Rank #1 (Strong Buy), is also worth considering.
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