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Accountable Care Organizations (ACOs)
As the health care industry tests new approaches to improve health care delivery, one of the most talked about concepts is the accountable care organization – or ACO. The term ACO means different things to different people.
What is an ACO?
The term “ACO” means different things to different people. We call our ACO-like initiatives collaborative accountable care (CAC). Each CAC program is a collaboration between Cigna and a group of health care professionals that’s responsible and accountable for the population it serves. The group must have a substantial primary care component, which can take any of the following forms:
The medical group is rewarded through a pay for performance structure if it meets targets for improving quality and lowering medical costs.
A key component to these programs is the care coordinator – a registered nurse employed by the medical group who works with individuals, especially people with chronic conditions, to ensure they get the screenings and follow-up care they need and have access to educational materials that can help them manage their health.
What’s Cigna Doing?
Results
Publications/News
Arizona
Cigna Medical Group
Effective January 1, 2010. Press release.
Colorado
Colorado Springs Health Partners (CSHP)
Effective April 1, 2012. Press release.
Connecticut
ProHealth Physicians, Inc.
Effective October 1, 2009. Press release.
Georgia
Piedmont Physicians Group
Effective June 1, 2010. Press release. Article (pdf).
Maine
Eastern Maine Healthcare Systems
Effective January 1, 2010.
Kennebec Region Health Alliance
Effective January 1, 2012. Press release.
Penobscot Community Health Care
Effective January 1, 2012. Press release.
Missouri
Mercy Clinic
Effective July 1 2010. Press release.
New Hampshire
Dartmouth-Hitchcock Clinic
Effective June 1, 2008. Press release.
New Jersey
Partners In Care
Effective September 15, 2011. Press release.
New York
Weill Cornell Physician Organization
Effective September 15, 2011. Press Release
WESTMED Medical Group
Effective March 1, 2012. Press release.
North Carolina
Cornerstone Health Care
Effective April 1, 2012. Press release.
Key Physicians
Effective April 1, 2012. Press release.
Tennessee
Health Choice, affiliated with Methodist Le Bonheur Healthcare
Effective August 1, 2011. Press release.
Holston Medical Group
Effective August 1, 2010. Press release.
The Jackson Clinic
Effective January 1, 2012. Press release.
Texas
HeathTexas Provider Network (HTPN)
Effective April 1, 2012. Press release.
Kelsey-Seybold
Effective June 2011
Medical Clinic of North Texas
Effective September 1, 2009. Press release.
Virginia
Bon Secours Medical Group
Effective March 1, 2012. Press release.
Fairfax Family Practice Centers
Effective March 1, 2012. Press release.
The term “ACO” means different things to different people. We call our ACO-like initiatives collaborative accountable care (CAC). Each CAC program is a collaboration between Cigna and a group of health care professionals that’s responsible and accountable for the population it serves. The group must have a substantial primary care component, which can take any of the following forms:
• A large primary care practice (examples: ProHealth Physicians in Connecticut, Medical Clinic of North Texas in the Dallas/Ft. Worth Metroplex)
• A multi-specialty group (example: Holston Medical Group in northeastern Tennessee)
• A fully integrated delivery system, including doctors and facilities (example: Piedmont Physicians Group in Atlanta)
• A Physician Hospital Organization (example: Health Choice in Memphis)
• A multi-specialty group (example: Holston Medical Group in northeastern Tennessee)
• A fully integrated delivery system, including doctors and facilities (example: Piedmont Physicians Group in Atlanta)
• A Physician Hospital Organization (example: Health Choice in Memphis)
Regardless of practice type, the common thread is that the medical group must be willing to accept responsibility and accountability for achieving the “triple aim” of improved quality (clinical outcomes), affordability (lower medical costs) and patient satisfaction.
The medical group is rewarded through a pay for performance structure if it meets targets for improving quality and lowering medical costs.
A key component to these programs is the care coordinator – a registered nurse employed by the medical group who works with individuals, especially people with chronic conditions, to ensure they get the screenings and follow-up care they need and have access to educational materials that can help them manage their health.
What’s Cigna Doing?
Cigna is now engaged in 28 patient-centered initiatives in 17 states, including six multi-payer pilots and 22 Cigna-only collaborative accountable care initiatives. Our collaborative accountable care initiatives encompass more than 270,000 Cigna customers and more than 4,000 physicians. Cigna launched its first CAC program in 2008. Our goal is to have 100 CAC programs with 1 million customers by 2014.
Results
• Medical Clinic of North Texas Results (Aug. 2011) – Press release
• Dartmouth-Hitchcock and Cigna Medical Group Results (March 2011) – Press release
• Dartmouth-Hitchcock and Cigna Medical Group Results (March 2011) – Press release
Publications/News
• From Volume to Value, published by FierceHealthPayer, Feb. 21, 2012
• Cigna White Paper (pdf) published November 2011
• MCNT Patient Case Study (pdf): Meet Celia
Cigna Collaborative Accountable Care Initiatives • Cigna White Paper (pdf) published November 2011
• MCNT Patient Case Study (pdf): Meet Celia
Arizona
Cigna Medical Group
Effective January 1, 2010. Press release.
Colorado
Colorado Springs Health Partners (CSHP)
Effective April 1, 2012. Press release.
Connecticut
ProHealth Physicians, Inc.
Effective October 1, 2009. Press release.
Georgia
Piedmont Physicians Group
Effective June 1, 2010. Press release. Article (pdf).
Maine
Eastern Maine Healthcare Systems
Effective January 1, 2010.
Kennebec Region Health Alliance
Effective January 1, 2012. Press release.
Penobscot Community Health Care
Effective January 1, 2012. Press release.
Missouri
Mercy Clinic
Effective July 1 2010. Press release.
New Hampshire
Dartmouth-Hitchcock Clinic
Effective June 1, 2008. Press release.
New Jersey
Partners In Care
Effective September 15, 2011. Press release.
New York
Weill Cornell Physician Organization
Effective September 15, 2011. Press Release
WESTMED Medical Group
Effective March 1, 2012. Press release.
North Carolina
Cornerstone Health Care
Effective April 1, 2012. Press release.
Key Physicians
Effective April 1, 2012. Press release.
Tennessee
Health Choice, affiliated with Methodist Le Bonheur Healthcare
Effective August 1, 2011. Press release.
Holston Medical Group
Effective August 1, 2010. Press release.
The Jackson Clinic
Effective January 1, 2012. Press release.
Texas
HeathTexas Provider Network (HTPN)
Effective April 1, 2012. Press release.
Kelsey-Seybold
Effective June 2011
Medical Clinic of North Texas
Effective September 1, 2009. Press release.
Virginia
Bon Secours Medical Group
Effective March 1, 2012. Press release.
Fairfax Family Practice Centers
Effective March 1, 2012. Press release.
Multi-Payer Medical Home Pilot Programs
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