Cigna, N.H. network launch state's largest ACO
Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations (ACOs).
Concord Hospital, Elliot Health System, LRGHealthcare, Southern New Hampshire Health System and Wentworth-Douglass Hospital comprise GHN, according to a press release. Each member is an independent, integrated healthcare delivery system consisting of primary care doctors, specialists and hospitals.
The program will benefit about 23,000 individuals covered by a Cigna health plan who receive care from among more than 900 GHN-participating healthcare professionals. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a GHN-participating physician will also have access to the benefits of the program.
Each of the GHN-participating organizations will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current physician and will not need to do anything to receive the benefits of the program. There also are no changes in any plan requirements regarding referrals to specialists.
Cigna will compensate GHN for the medical and care coordination services its participating organizations provide. Additionally, the organizations may be rewarded through a pay-for-performance structure if they meet their targets for improving quality and lowering medical costs.
The principles of the patient-centered medical home are the foundation of Cigna's collaborative accountable care initiatives. Cigna is now engaged in 32 patient-centered initiatives in 17 states, including six multi-payor medical home pilots and 26 Cigna-only collaborative accountable care initiatives. The collaborative accountable care initiatives encompass more than 270,000 Cigna customers and more than 4,000 physicians.