Blog Post

Cigna's Collaborative Care program is expanding—to cancer care

May 18, 2016

    We recently spoke with Cigna about the expansion of its Collaborative Care Initiative. Keep reading to learn how Cigna is helping cancer practices improve affordability and patient care.

    Program overview

    The aim of Cigna’s Collaborative Care program, a model similar to an oncology medical home, is to improve affordability and provide cancer patients a point of care that ensures all of their needs are met. To help providers meet this goal, Cigna provides participants financial incentives, data, and operational support. In return, participating practices are required to provide patients 24-7 access, provide an RN oncology care coordinator for attributed patients, utilize a shared decision making process supported by evidence based guidelines, and report on six quality metrics including palliative care assessment and distress screening. As the program matures, it is likely the number of metrics will expand.

    Resources Available to Participating Practices

    Financial Incentives Data Operational Support
    • Patient management fee
    • Opportunity to share in savings (based on national spending benchmarks)

    • Daily report on inpatient admissions
    • Aggregated quarterly reports on attributed patient resource utilization, including ED visits

    • Oncology non-clinical navigator that functions as a single point of contact for participating groups
    • Case manager that works with RN care coordinator when patients have complex co-morbidities
    • Next day report on patients admitted for inpatient care
    • National learning collaborative for participants to share best practices


    Program Leverages Prior Authorization Process

    authorization process

    To reduce overall care costs and ensure patients receive prompt attention, Cigna leverages its internal prior authorization process to alert participating providers when a patient is admitted for an inpatient stay. The system is as effective as it is simple: whenever an inpatient admission is authorized for an attributed patient, the Cigna oncology navigator is alerted. The navigator then generates a report that is sent to the patient’s oncology care coordinator within 24 hours. Clinicians can use this expedited information to reach out to their patients.

    A successful past

    Cigna’s program is currently being piloted at several independent oncology practices throughout the U.S., including the Virginia Cancer Institute in Richmond, Va., Regional Cancer Care Associates in Hackensack, N.J., and Florida Cancer Specialists & Research Institute in Fort Myers, Fla. Because the program is new to oncology, there is little data on outcomes to be shared.

    However, the program’s track-record in primary care, where it has been partnering with practices to improve patient care and reduce costs since 2008, provides insight into its potential value. For instance, the WestMed Medical Group, an early partner in the initiative, reported reducing outpatient costs 4.2% and reducing ED visits by 23% and hospital admissions by 64%. We will be sure to keep you up-to-date as we learn more about the program’s impact on cancer care.

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