Cigna, Physician Health Partners Form ACO

In continuation of its strategy to enhance its Collaborative Accountable Care (CAC) initiative, health insurer Cigna Corp. (CI) recently tied up with Physician Health Partners.

The Accountable Care initiative formed with Physician Health Partners has become effective Jan 1, 2014 onwards. The program will benefit more than 27,000 customers of Cigna who are covered under the Cigna health plan, and receive care from more than 300 physicians related to Primary Physician Partners and South Metro Primary Care.

This initiative is in sync with Cigna’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 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 service offered, this model intends to improve the health of individuals and communities besides curtailing rising healthcare costs.

Through the CAC program, physicians of Primary Physician Partners and South Metro Primary Care 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.

Enrollees in the program will also be able to receive 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 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.

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 actively involved with ACO initiatives.

Cigna currently holds a Zacks Rank #1 (Strong Buy). Another top-ranked stock – Kemper Corp. (KMPR) carrying the same Zacks Rank as Cigna, is also worth considering.