CIGNA, Piedmont Physicians launch ACO pilot program

CIGNA and the Piedmont Physicians Group, part of Atlanta-based Piedmont Healthcare have launched an accountable care organization pilot program, designed to provide a comprehensive, accountable and collaborative approach to medical care.

"Piedmont physicians have been at the forefront of patient-centered care for over 100 years in Georgia," said James Sams, MD, the group's medical director. "The launch of this program is a natural progression for leading the charge for better patient outcomes."

The program, which began July 1, is focused on approximately 10,000 individuals covered by a CIGNA health plan who receive care from one of the Piedmont Group's more than 100 primary care physicians.

During the pilot, a group practice will monitor and coordinate the medical care of all patients covered by CIGNA in the ACO.

According to officials of the Bloomfield, Conn.-based insurer, the program with Piedmont is the first ACO to operate in Georgia. The company expects that patients who need help monitoring and treating chronic conditions, such as diabetes, will see the most immediate benefits.

"We believe that we can achieve better clinical outcomes by adopting a patient-centered model of primary care," said David Epstein, CIGNA's senior medical director for Georgia. "Healthcare in the United States has shifted away from prevention and primary care, which has resulted in a 'disease care' system that relies more on specialist intervention and rescue procedures rather than improving health and providing greater value to patients. The patient-centered model places the focus back where it belongs – on improving the health of individuals through comprehensive primary care services and delivering better outcomes through enhanced care coordination."

Under the pilot, the Piedmont Physicians Group will be pai, as usual for the medical services they provide, plus an additional fee for care coordination and other medical home services. Physicians will also be rewarded through a "pay for performance" structure if they meet targets for improving quality and lowering medical costs.

After 12 months, the pilot program will be evaluated by CIGNA.

Other CIGNA programs include multi-payer pilots in Colorado, New Hampshire, Pennsylvania and Vermont, as well as CIGNA-only accountable care organization pilots in Connecticut, New Hampshire and Texas.