CIGNA says ACO pilots show lower costs, better quality of care
A release of preliminary results by CIGNA from two accountable care pilot projects shows both are achieving lowered growth in healthcare costs while also improving quality of care.
A project with the Dartmouth-Hitchcock Medical Center in New Hampshire shows the provider is closing gaps in care 10 times better than market average, while another program at the Cigna Medical Group in Phoenix, Ariz., has lowered annual average costs per patient by $336.
[See also: NEJM article spotlights financial risks associated with ACOs; CIGNA, Piedmont Physicians launch ACO pilot program]
"Through our patient-centered collaborative accountable care initiatives we aim to transform the medical delivery system by rewarding physicians for results rather than volume," said Dick Salmon, CIGNA's national medical director for performance measurement and improvement. "We expect a focus on coordinated, comprehensive care will strengthen the patient-doctor relationship and result in greater value through better outcomes for patients and lower overall medical costs. We're still in the early stages, but we're clearly on the right track toward achieving these goals, which is why we plan a major expansion of these programs in 2011."
CIGNA is running eight accountable care programs throughout the country and participating in four multi-payer pilots. According to Salmon, the company expects to expand that to as many 30 programs by the end of the year.
Through the programs, CIGNA is sharing "gaps in care" data with care coordinators at participating providers. Using this information, care coordinators can work directly with patients to ensure follow-up appointments are scheduled, prescriptions are filled or additional medical tests are completed. In the case of Dartmouth-Hitchcock, this has resulted in a 10 percent improvement in the practice's overall closure rate for gaps in care compared with physician practices without coordinated care.
"With the gaps-in-care and other patient-specific data CIGNA provides, we are able to more effectively follow up with patients to see they get any additional care they may need," said Barbara Walters, MD, senior medical director for Dartmouth-Hitchcock. "Identifying patients who may have diabetes and helping them control their blood sugar level, or ensuring that someone being discharged from the hospital receives appropriate follow-up care to prevent readmission, presents a significant opportunity for improving health and lowering overall medical costs."
Salmon pointed out that while much attention is focused on provider groups developing accountable care organizations, the CIGNA pilots are different in that they place emphasis on creating a patient-centered medical home with an emphasis on direct communication with providers.
"CIGNA physicians and nurses have frequent contact with doctors and nurses at the physician practices to help with coordination of patient care," Salmon said.
