ACOs can help deliver population health, Cigna exec says


Collaborative care models like accountable care organizations are the "tip of the iceberg" helping insurers deliver population health to consumers, says Harriet Wallsh, a clinical program director with Cigna Collaborative Care.

"We're in the informative stages of where I think we could be going," Wallsh said of the healthcare industry in an interview with RevCycle Intelligence. "We can do great things over time if we can connect and really coordinate care."

Cigna is a leader in the ACO movement, launching its first collaborative care arrangement in 2008 and now has more than 100 collaborative care programs in place, FierceHealthPayer previously reported. Wallsh said Cigna's collaborative care program allows the insurer "to improve quality, affordability and the experience of care" for its members.

One way Cigna succeeds is in selecting which providers to partner with in its programs. Wallsh said the company wants a provider that is aligned with achieving better health, affordability and experience for consumers. Cigna uses an intensive evaluation to ensure that providers really want to work with them.

To that end, Cigna asks certain questions of the providers, including how they advance care delivery, whether they have electronic records already in place and if they have organizational direction and support to transition to a value-based payment system.

Providers also "must be ready and willing to accept accountability for improving the health of the population it serves," Dick Salmon, Cigna's national medical director for performance measurement and improvement, told FierceHealthPayer in a previous interview.

Essentially, Cigna wants to form collaborative care relationships with providers based on open communication, clear standards and trust.

Cigna is also looking to expand its current collaborative care model to specialty groups, hospitals and smaller groups. "The goal is to improve the quality and affordability and the experience of care, no matter where a Cigna customer seeks care," Wallsh added.

To learn more:
- read the RevCycle Intelligence article

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