Cigna, PremierCare Northwest Form ACO - Analyst Blog
Continuing with the strategy to enhance its Collaborative
Accountable Care (CAC) initiative, health insurer
) has tied up with PremierCare Northwest in Arkansas.
The Accountable Care initiative formed with PremierCare Northwest is the first in Arkansas and is already in effect from Jan 1, 2014. The program will benefit more than 5,000 customers of Cigna who are covered under the Cigna health plan, and receive care from more than 117 physicians related to PremierCare primary care doctors and over 30 specialists.
This step by Cigna is in sync with the company's goal to improve the quality of care and service provided to customers, besides lowering healthcare costs and enhancing overall value.
Cigna's CAC initiative is similar to an Accountable Care Organization (ACO). An ACO is a group effort by health care 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 services offered, this model intends to improve the health of individuals and communities while, at the same time, curtailing rising healthcare costs.
Through the CAC program, physicians of PremierCare will monitor and coordinate all 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 poised to benefit the most from this initiative.
The enrollees under the program will also have an additional advantage of receiving the services of registered nurses. They will coordinate patient clinical care, educate patients about various health conditions, and counsel them on proper health care 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 all along, sending reminders about screenings required and recommending direct medical help. Simultaneously, they will educate patients by encouraging increased participation 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 health care to patients.
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 in 2008 and 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 enthusiastic about ACO initiatives.
Cigna currently holds a Zacks Rank #4 (Sell). A better ranked stock, Kemper Corp. ( KMPR ) with Zacks Rank #2 (Buy) is worth considering.
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