October 16, 2012

Cigna forms ACO contract with New Haven doc group

Bloomfield insurer Cigna has signed another collaborative accountable care contract in Connecticut, this time partnering with a group of doctors in New Haven.

The new partnership with the New Haven Community Medical Group aims to expand patient access to health care, improve care coordination, and achieve the "triple aim" of improved health outcomes (quality), cost effective care and increased patient satisfaction.

The program will impact nearly 18,000 individuals covered by a Cigna health plan who receive care from New Haven Community Medical Group's 583 physicians, including 216 primary care doctors and 367 specialists.

The New Haven Community Medical Group is an integrated network of physicians and other health care professionals that works in clinical collaboration with the Yale-New Haven Hospital.

Under the program, New Haven Community Medical Group doctors monitor and coordinate many aspects of an individual's medical care. Patients continue to go to their current physician and automatically receive 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.

The program will also include new care coordinators, employed by the medical group, who 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 collaboration between the medical group and Cigna.

Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical 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.

Cigna will compensate the New Haven Community Medical Group 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.

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