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Cigna and HeartWell have launched a program to improve quality and cost of care for people diagnosed with chronic coronary artery disease.
The program is part of Cigna Collaborative Care, a value-based model that uses incentives to engage health care providers and helps drive improved health, affordability and patient experience.
Cigna Collaborative Care initially focused on large primary care physician groups and later expanded to include hospitals, small primary care practices and specialists, such as orthopedists, oncologists and cardiologists.
Under the new initiative, HeartWell will continue to be paid for the medical services it provides to its Cigna patients. It will also be eligible to earn shared savings if it meets certain quality targets and if the actual cost for an entire episode of care is below a risk-adjusted expected cost. An episode of care includes pre-care, cardiovascular procedures (such as cardiac catheterizations and coronary angioplasty), medications, recovery and follow-up care through 12 months following the procedure.
After the episode of care has ended, Cigna will evaluate all of the claims for that episode, adjust for risk and determine if the total actual cost is below the expected cost. If it is, HeartWell will receive a portion of those savings – but only if it also meets specific quality targets.
“We’ve had solid results from our ongoing Cigna Collaborative Care arrangements with primary care physician groups and we’re also having success as we extend our value-based arrangements into specialty care. We look forward to collaborating with HeartWell as we take this important next step into value-based cardiac care,” said Marco Vitiello, MD, Cigna's medical executive for South Florida.
Cigna, HeartWell, Cigna Collaborative Care, Artery disease, US