Cigna and Duke Connected Care have teamed up to form an ACO-like relationship that aims to improve population health of some 10,000 individuals in North Carolina covered by Cigna.
The private market has been adopting its own versions of the Medicare-run program, looking to achieve the so-called triple aim of reduced cost, improved care and improved patient experience. It’s likely to accelerate in lieu of the recent announcement from HHS that as much as 30 percent of Medicare payments could come in the form of bundled payments, ACOs and other new reimbursement model by 2016, and more after that.
The Cigna-Duke collaboration is one of 10 such initiatives in the Carolinas. More than 1,200 Duke physicians are a part of the program. A key part of the success to any level of coordinated care is what technologies are used and how. As part of the collaboration, Duke Connected Care will monitor and coordinate all aspects of each participating individual’s care using EMRs data in an effort to prevent hospitalizations.
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For its part, Cigna said its wide range of data will prove useful for Duke and the coordination efforts.
“For example, when a doctor writes a prescription, he or she may not know whether that prescription was actually filled,” spokeswoman Jill Holliday said. “Cigna is able to see from claims data whether there is a claim for that prescription.
More broadly, we are further developing the capability for bilateral health information exchange and to share population health management analytics with the health care professional partners who are collaboratively working with us to improve healthcare outcomes,” she added.
Hartford-based Cigna has been particularly bullish on ACOs, predating the Affordable Care Act, and now has 114 Collaborative Care agreements with large physician groups in 28 states. Cigna said it’s version of collaborative care has helped hold the line on healthcare costs by improving things like missed screenings and prescription refills.
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Duke will supply clinical care coordinators for Cigna members, helping with chronic conditions and other barriers. The Duke coordinators are aligned with a Cigna case manager to help with coordination.
