Value-Based Care

Value-Based Care

We collaborate with providers to help drive better health outcomes and savings for you and your employees.

Cigna Collaborative Care® Programs help lead the way to heathier employees and a better bottom line.

Our approach to value-driven care is simple and effective. We collaborate with high-performing* providers to create the right incentives that improve their performance and help them to deliver personalized care.

By delivering actionable insights to providers powered by data, analytics, and clinical expertise, we help them provide whole-person health support that helps drive better health outcomes for your employees, and better savings for you.

Cigna Collaborative Care Programs

Our Cigna Collaborative Care programs give your employees access to providers who have committed to work together across care settings to deliver coordinated, quality, and cost-efficient care for better health outcomes by promoting whole person health and well-being.

Cigna Accountable Care Program (ACO) for Primary Care

Our ACO programs connect data, people, and clinical programs for better primary care by:

  • Driving better health outcomes by helping providers identify quality and medical cost improvement opportunities, to continuously improve patient outcomes.
  • Identifying gaps in care and proactively addressing your employees' needs with embedded care coordinators that work with clinicians, case managers, pharmacists, and behavioral specialists.
  • Delivering daily claim data that helps to identify patients with the greatest risk and potential to drive high costs, such as gaps in care, recent hospitalizations, ER visits, prescription utilization, delayed behavioral care, chronic care, and preventive care.

Specialist Programs

To impact the greatest cost drivers, our Cigna Collaborative Care specialist programs include episodes of care, nephrology, oncology, and outpatient surgical bundles to effectively deliver care while lowering costs for you through:

  • Data and insights with our specialty group partners to identify potentially avoidable complications while controlling unnecessary costs through a single payment for the care a patient receives in the course of treatment for a specific illness, condition, or medical event.
  • Bundled Surgery Program that includes high performing* surgeons and coordinated care with a no-cost** share benefit that provides predictable surgical bundled payments, and an overarching high-touch service experience to make it easy for your employees to get to these providers.
  • Oncology Programs that work with local and community-based oncology practices to improve the cost, quality, and coordination of care for customers in active cancer treatment.

Hospital Program

Our relationships with hospitals focus on providing access to better inpatient care by:

  • Evaluating and promoting hospitals based on hospital quality, safety, and efficiency performance.
  • Focusing on quality measures that improve the quality of care delivered such as readmission rates, quality process of care measures, patient experience and safety, reducing primary C-section rates, and eliminating health disparities.

How we do it

Convenient Access

Creating simple pathways that connect our customers to affordable, high-performing* providers through:

  • Virtual care (also called telehealth)1
  • Mobile and web tools with cost and quality ratings
  • 24/7/365 phone/chat
  • One Guide® and clinical support teams

Care Coordination

Seamlessly coordinate care to promote whole-person health and well-being:

By helping providers leverage our case management, disease management, behavioral health, and pharmacy programs, we can help them efficiently deliver care to help drive down total medical costs.

Quality Care

Measuring the quality and efficiency of care delivered by:

  • Identifying specific quality and medical cost improvement opportunities
  • Ensuring that best practice protocols and Evidence Based Medicine (EBM) guidelines are met
  • Supporting national patient safety initiatives such as the national partnership for patients and the CMS Hospital Value-Based Purchasing (HVBP) Program

The Future of Care Delivery – Today

Learn how Cigna can deliver better value to your organization. Contact your broker or Cigna representative today.

1Cigna provides access to virtual care through national telehealth providers as part of your plan. This service is separate from your health plan's network and may not be available in all areas.

*Providers identified as having top results, based on Cigna's 2020 Quality, Cost Efficiency, and Cigna Care Designation Methodology White Paper. Some doctors are included in Tier 1 due to contractual obligations and network adequacy requirements and may not meet Cigna quality and/or cost-efficiency measures.

**Surgery is covered at 100% after your deductible is met if you have a high deductible health plan with a health savings account (or HSA) when you participate and use the providers in the program. Generally, facility and professional services from admission through discharge are included in the program benefit. Charges for covered expenses not included in the program are subject to your health plan’s applicable copays, coinsurance, and deductible, if any.