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Cigna Transition to Value-Based Health Care Results in $600 Million in Savings

Cigna exceeds goal of having 50 percent of payments to health care professionals made through alternative payment arrangements, moving away from fee-for-service models.

Originally Published by Cigna.

Global health service company Cigna has exceeded its value-based care goal of having 50 percent of U.S. Medicare and commercial health care provider payments through alternative payment arrangements in the company’s top 40 markets by year-end 2018. Cigna established the goal in 2015 to accelerate the transition to alternative payment models that link health care provider payments to both quality and affordability.

Cigna launched value-based care delivery a decade ago to begin to transition to a health care delivery system that pays health care providers based on improved health outcomes instead of the traditional fee-for-service model, which pays providers based on volume. The move helped the company shift 50.5 percent of provider payments to alternative payment arrangements, and improve the quality of health care for customers resulting in medical cost savings of more than $600 million from 2013-20171. In addition, it has contributed to Cigna maintaining the industry’s lowest medical cost trend for six consecutive years2.

“Cigna’s focus on quality and affordability enabled the company to exceed its 50 percent alternative payment goal, offering more value for our customers’ and clients’ health care dollars,” said Scott Josephs, MD, chief medical officer at Cigna. “This is a critical milestone as we work to accelerate the pace of change in health care delivery in the United States. Our commitment to value-based care and alternative payment models is driving better health outcomes, increased affordability and improved patient experience for the people we serve.”

Today, more than 3.6 million Cigna commercial customers access value-based care through 240+ primary care provider organizations, 500+ hospital facilities and 270+ specialist programs in six disciplines, including 245+ Episodes of Care programs3. Ninety-six percent of Cigna customers in the company’s top 40 markets are within 15 miles of at least three participating primary care providers4. In addition, 85 percent of Cigna Medicare Advantage customers access care through value-based arrangements2.

Cigna’s transition to value-based health care delivery has resulted in significant improvements in health care for its customers. Top-performing accountable care program health care providers demonstrated a quality performance of 11 percent better than the market5 with 92 percent of providers either meeting or exceeding quality benchmarks6. Cigna collaborates with participating providers who receive clinical support, data and insights to help improve health outcomes. According to a survey7 of Cigna commercial accountable care program providers:

  • 92 percent say the insights and guidance Cigna provides help them improve performance and outcomes.
  • 95 percent say their relationship with Cigna is collaborative and consultative rather than transactional.
  • 95 percent say it is easy to do business with Cigna.

“Cigna’s combination with Express Scripts will further accelerate our transition to value-based health care, including expanding outcome-based relationships with pharmaceutical manufacturers to incentivize improved patient health,” said Dr. Josephs. “Cigna has led its industry with the lowest medical cost trend and our combination will help improve both quality and affordability.”

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