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Cigna Value-Based Care Participation Tops 50%, Saving $600M

Cigna has passed the halfway mark on its journey to value-based care, saving more than $600 million along the way.

Value-based care adoption for payers

Source: Cigna

By Jennifer Bresnick

- Cigna has surpassed its goal of having 50 percent of its Medicare and commercial health reimbursements tied to value-based care models in top markets by the end of 2018, the payer announced.

Between 2013 and 2017, value-based care arrangements have produced medical cost savings of more than $600 million, illustrating how shifting away from traditional fee-for-service reimbursement can help the industry control spending at scale.

“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.”

More than 3.6 million of Cigna’s commercial customers access care through a value-based arrangement. 

More than 240 primary care organizations, more than 500 hospitals, and over 270 specialist programs in six areas of care are engaged in reimbursement through some type of pay-for-performance contract, the company said.  

Eighty-five percent of its Medicare Advantage customers are also receiving care under value-based arrangements.

The company states that value-based approaches have resulted in measurable improvements in care quality while sustaining high satisfaction from provider participants.

Top-performing accountable care providers achieved 11 percent higher performance on quality measures than the market at large, with 92 percent either meeting or exceeding benchmarks for care delivery.

Cigna credits its reliance on data analytics and commitment to sharing guidance with its participating providers for high rates of success.

Ninety-two percent of providers said that Cigna’s clinical support, insight, and guidance helps them to improve outcomes and performance, while 95 percent stated that they have a collaborative and positive relationship with the payer.

Cigna recently announced that its $67 billion acquisition of Express Scripts has been completed, bringing new capabilities to help continue progress towards a value-based environment.

“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 Josephs.

“Cigna has led its industry with the lowest medical cost trend and our combination will help improve both quality and affordability.”

Overall, the industry is fast approaching Cigna’s recent milestone.  At the end of 2018, the Health Care Transformation Task Force announced that 47 percent of its members’ business is now tied to value-based arrangements in some capacity.

The Healthcare Learning & Action Network has seen similarly strong interest in moving away from traditional arrangements: the organization found that 34 percent of the payer market, who are responsible for 77 percent of the US population, are now engaged in value-based models.

The trend is likely to accelerate in 2019 as CMS and private payers nudge providers into more risk-sharing arrangements and other value-based models in an effort to contain costs and improve quality.


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