ACO Pilots Show Lower Cost Increases, Improved Care

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imagePreliminary results from two accountable care organization (ACO) pilot projects undertaken by CIGNA indicate that both are achieving lowered growth in healthcare costs as well as simultaneous improvements in the caliber of patient care.

According to data released by CIGNA late last week, a project with the Dartmouth-Hitchcock Medical Center in Hanover, New Hampshire shows the provider is closing gaps in care 10 times better than market average. A second pilot initiated at Cigna Medical Group in Phoenix, Ariz., has lowered annual average costs per patient by $336.

“Through our patient-centered collaborative accountable care initiatives, we aim to transform the medical delivery system by rewarding physicians for results rather than volume,” explains Dick Salmon, CIGNA's national medical director for performance measurement and improvement. He notes that CIGNA believes a focus on coordinated, comprehensive care will strengthen patient-doctor relationships, resulting in greater value through better outcomes for patients as well as 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,” Salmon adds.

CIGNA is currently operating eight accountable care programs throughout the U.S. and participating in four multi-payor pilots. Plans presently entail an expansion to as many as 30 programs by the end of the year.

Under the program umbrella, CIGNA is sharing “gaps-in-care” data with care coordinators at participating providers. Care coordinators utilize this information to work directly with patients to ensure that follow-up appointments are scheduled, prescriptions are filled, and/or additional medical tests are completed. At Dartmouth-Hitchcock, this has resulted in a 10% 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 that they get any additional care they may need,” states Barbara Walters, MD, the hospital’s senior medical director.

Moreover, Salmon notes that while a significant portion of attention is focused on provider groups developing ACOs, the CIGNA pilots differ from that mold because they place emphasis on creating patient-centered medical homes with a foccus 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,” he concludes.