HeartWell, Cigna Collaborate to Improve Quality, Cost for Treatment of 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.
The quality targets include:
* Reduced number of hospital readmissions
* Reduced frequency of post-surgery complications, including deep vein thrombosis (blood clots in deep veins), pulmonary embolisms (blockage of arteries in the lungs), wound infections and strokes.
"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
"At HeartWell, we believe in working closely with patients and their primary care physician to keep them healthy. We strive to help our patients live better lives through the high-quality care we provide," said
This is Cigna's first chronic episodes-of-care arrangement for cardiology.
"Chronic conditions - such as diabetes and heart disease - can have a significant impact on an individual's overall health and quality of life. Our hope is that initiatives like this will help improve lives and contain health care costs by reducing the need for emergency room visits and hospitalizations," said
Cigna has episodes-of-care arrangements for other medical specialties, including orthopedics, oncology, gastroenterology and obstetrics/gynecology. It also has pay-for-performance arrangements for obstetrics/gynecology and oncology.
About HeartWell
HeartWell's physicians are among the most skilled and respected doctors in the area who all provide personalized care--including education about preventive measures--for patients who have, or are at risk for, cardiac and vascular diseases.
Among the many services and specialties are office based services such as arrhythmia management, cardiovascular research, coronary disease management; diagnostics such as carotid ultrasound studies, echocardiography, smoking cessation strategies; and hospital/outpatient services including cardiac catheterization, interventional cardiology and implantation of pacemakers and defibrillators. For more information, visit www.heartwell.com.
About Cigna
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