A study published in the November issue of the leading policy journal Health Affairs shows that Cigna's (NYSE: CI) collaborative accountable care (CAC) model has favorable quality of care and total medical cost trends. The study reports interim quality and cost results among three geographically and structurally diverse physician practices in Arizona, New Hampshire and Texas. Results suggest that a shared savings accountable care model with collaborative support from the payer can enable physician practices to take meaningful steps toward full accountability for care quality and efficiency.
Cigna's CAC model, based on principles aligned with accountable care organizations (ACOs), is focused on the “triple aim” of improving health outcomes, reducing medical costs and increasing patient satisfaction. Participating physician groups focus on closely monitoring individuals who are at high risk for adverse health events, including patients with chronic conditions such as diabetes or cardiovascular disease.
The study in Health Affairs reports on 2010 results for quality of care and total medical costs at Dartmouth-Hitchcock in New Hampshire, Medical Clinic of North Texas (MCNT), and Cigna Medical Group of Arizona (CMG).
The study showed that CMG’s total medical costs for 2010 were significantly reduced ($27.04 per patient per month) compared with other practices in the same geographic area (p < 0.10). Compared with expected costs, Dartmouth-Hitchcock and MCNT achieved performance improvements in their per patient, per month costs ($1.78 and $6.56 respectively), although CMG showed a decrease of $4.94. The study also showed that the three practices out-performed their comparison group peers on all care quality measures, with one exception.Aggregate risk-adjusted medical costs per patient per month were calculated to evaluate the effect of the initiative on total medical expenditures. Performance improvement was based on the difference between a practice’s risk-adjusted expected costs for 2010 and its actual costs in the same year. The study assessed care quality by comparing compliance rates between practices in the initiative and their comparison groups for each patient on 69 evidence-based measures of care.