Value-Based, Accountable Care Is Here to Stay for Cigna
By - The healthcare world is continuously evolving, with healthcare payers and providers working to find the best way to give patients high-quality, affordable care. Accountable care organizations (ACOs) leverage care and work to improve patient outcomes while reducing costs. However, it is essential for agreements between healthcare providers and payers to allow important health data to be shared and made actionable.
If that relationship is not a good one, it will be difficult to provide high-quality, collaborative care at the right price.
Harriet Wallsh, a clinical program director with Cigna Collaborative Care, discussed with RevCycleIntelligence.com how healthcare is evolving and how Cigna is working to provide its patients with high-quality, affordable care.
For example, Cigna Collaborative Care has very similar healthcare goals as ACOs, Wallsh explained.
“It’s our opportunity to improve quality, affordability and the experience of care for Cigna customers,” Wallsh said. “It’s hitting that triple aim in a way that adds value for our customers – the patients.”
When it comes to choosing organizations to work with and form a collaborative care organization, Wallsh explained that first and foremost Cigna wants a group that is aligned with achievement of the triple aim goals of better health, affordability, and experience through a meaningful relationship with Cigna. She said that some important questions to ask are: How are they advancing the way they deliver care? Do they have electronic health records? Do they have organization direction to transition from fee-for-service to fee-for-value?
“We understand not all groups are as advanced as others, but if they’re willing to take that on, then that’s a positive sign,” Wallsh said. “You want to see if people are interested in the collaborative partnership, and you look at the tools and infrastructure they have.”
Overall, Cigna wants organizations that are a good long-term partner that is interested in improving the quality and the affordability of care that they deliver, as well as improving the experience of care for their patients, Wallsh said. Essentially, it is an intensive evaluation process on both sides, and Cigna’s partners have to be sure they want to work with Cigna and vice versa.
When asked about the future of healthcare – and ACOs – Wallsh said that while it’s still the early stages, she doesn’t think the collaborative care model will disappear.
“We’re in the informative stages of where I think we could be going,” Wallsh said of the healthcare industry as a whole. “We can do great things over time if we can connect and really coordinate care.”
Additionally, Wallsh stated that this is an incredibly good time to be in healthcare and a very exciting time.
“We are now capable of delivering population health to thousands of people at a time,” Wallsh said. “This is the tip of the iceberg for us.”
Wallsh added that Cigna is now looking into creating collaborative care for specialty groups, hospitals and smaller groups. People do not seek healthcare just in large groups, Wallsh said. Cigna’s goal is to ensure the majority of high cost individuals seeking care are treated by health care professionals in a value-based relationship “so everybody can get that benefit from an enhanced touch.”
“The goal is to improve the quality and affordability and the experience of care, no matter where a Cigna customer seeks care,” Wallsh said.
