- Value-based reimbursement model uses
incentives to engage health care providers
- Helps drive improved health,
affordability and patient/provider experience
- Cigna's first value-based reimbursement
arrangement for kidney disease specialty
Cigna (NYSE: CI) and Fresenius Medical Care North America
(FMCNA) have launched a national program to drive quality and lower
the cost of care for people with end-stage kidney disease who are
undergoing dialysis.
This Smart News Release features multimedia.
View the full release here:
http://www.businesswire.com/news/home/20170207005537/en/
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, patient satisfaction
and provider experience. Cigna Collaborative Care initially focused
on large primary care physician groups and later expanded to
include hospitals, smaller primary care practices and specialists,
such as doctors and other providers who treat cancer, heart
disease, and now kidney disease.
Under the new initiative, FMCNA will continue to be paid for the
kidney dialysis services it provides to its Cigna patients, while
its affiliate, Fresenius Health Partners, will assume separate
responsibility to provide management of medical costs and to
improve patient outcomes.
Implementing its proprietary care coordination model for this
purpose, FMCNA may be eligible for additional reimbursement if it
achieves these goals so long as the dialysis clinics maintain or
improve their star ratings in the Centers for Medicare &
Medicaid Services (CMS) Dialysis Facility Compare (DFC) quality
rating. Cigna will evaluate outcomes for a number of quality
measures which correlate directly to the total cost of care and
overall patient experience.
One of the program’s goals is to reduce emergency room use and
hospital admission for dialysis by keeping patients healthier and
providing them with additional access to dialysis at Fresenius
Kidney Care outpatient facilities as needed.
“By working together to coordinate and expand access to care, we
can help people get the right care at the right time in the right
setting. This enables us to achieve all the elements of what we
call the ‘quadruple aim’ – better health, affordability, patient
satisfaction and provider experience,” said Scott Josephs, M.D.,
Cigna vice president and national medical officer.
As part of the agreement, specialized nurses and service
coordinators from FMCNA’s Care Navigation Unit (CNU) will
coordinate care with a patient’s current doctors, identify
opportunities to engage with them to avoid complications and
unnecessary services, and coordinate services with Cigna medical
and behavioral case management. Thus, FMCNA will have an expanded
assessment role while delivering care and will help manage the
patient’s medical needs both in and outside the dialysis
clinic.
“We are proud to collaborate with Cigna in this joint effort to
improve the quality and affordability of care. With the CNU, we are
focusing on the unique clinical and psycho-social needs of each
patient and able to foresee issues before they arise, helping
patients, their families and their providers respond more quickly
as they happen,” said William McKinney, president of FMCNA’s
Integrated Care Group. “This heightened level of service is part of
our commitment to improve the quality of life for every patient,
every day.”
“Innovating the care and management of patients with kidney
failure is at the core of what we do, and it is heartening to
collaborate with Cigna, an organization that is similarly dedicated
to making the health care system better,” said Bill Valle, FMCNA’s
chief executive officer. “More than ever, chronically ill patients,
such as those with kidney failure, deserve coordinated and
integrated care, and in partnering with Cigna, we will bring to its
customers a demonstrated ability to improve patient experience and
health outcomes and reduce costs.”
The new initiative with FMCNA is Cigna’s first value-based
arrangement with kidney disease specialists. It is consistent with
Cigna's commitment to have 50 percent of its reimbursements in
alternative payment models and 90 percent in value-based
arrangements by 2018.
Value-based arrangements come in a variety of forms that reward
physicians and other providers for the quality and the value of the
care they provide. In a pay-for-value model, they are compensated
for achieving specific quality and cost targets. In an
episodes-of-care arrangement, they are compensated for all of the
care they provide related to a specific procedure – for example, a
hip replacement or other surgery – including a defined time prior
to the procedure, the procedure itself, recovery and follow-up care
for a defined time after the surgery.
About Cigna
Cigna Corporation (NYSE: CI) is a global health service company
dedicated to helping people improve their health, well-being and
sense of security. All products and services are provided
exclusively by or through operating subsidiaries of Cigna
Corporation, including Connecticut General Life Insurance Company,
Cigna Health and Life Insurance Company, Life Insurance Company of
North America and Cigna Life Insurance Company of New York. Such
products and services include an integrated suite of health
services, such as medical, dental, behavioral health, pharmacy,
vision, supplemental benefits, and other related products including
group life, accident and disability insurance. Cigna maintains
sales capability in 30 countries and jurisdictions, and has more
than 90 million customer relationships throughout the world. To
learn more about Cigna®, including links to follow us on Facebook
or Twitter, visit www.cigna.com.
About Fresenius Medical Care North America
Fresenius Medical Care North America is the premier health care
company focused on providing the highest quality care to people
with renal and other chronic conditions. Through its
industry-leading network of dialysis facilities, outpatient cardiac
and vascular labs, and urgent care centers, as well as the
country’s largest practice of hospitalist and post-acute providers,
Fresenius Medical Care provides coordinated health care services at
pivotal care points for hundreds of thousands of chronically ill
customers throughout the continent. As the world’s largest fully
vertically integrated renal company, it offers specialty pharmacy
and laboratory services, and manufactures and distributes the most
comprehensive line of dialysis equipment, disposable products, and
renal pharmaceuticals. For more information, visit the FMCNA
website at www.fmcna.com
About Fresenius Health Partners
Fresenius Health Partners is the insurance component of
Fresenius Medical Care North America specializing in intensive care
coordination and disease management services for individuals with
Chronic Kidney Disease or End Stage Renal Disease. Launched in 2006
and rapidly emerging as the recognized leader in providing
comprehensive healthcare coverage for renal patients, Fresenius
Health Partners works with government payors, private health plans
and accountable care organizations to improve the health and
outcomes of renal patients while at the same time reducing the
total cost of their care. For more information on Fresenius Health
Partners’ programs, including the Fresenius Seamless Care ESCOs,
visit www.freseniushealthpartners.com
View source
version on businesswire.com: http://www.businesswire.com/news/home/20170207005537/en/
CignaMark Slitt, 860-226-2092mark.slitt@cigna.comorFresenius
Medical Care North AmericaJon Stone,
781-392-4680jonathan.d.stone@fmc-na.com
Cigna (NYSE:CI)
Historical Stock Chart
From Mar 2024 to Apr 2024
Cigna (NYSE:CI)
Historical Stock Chart
From Apr 2023 to Apr 2024
