The challenge

Quality measurement is critical in the pursuit of better patient outcomes. But physician practices often spend significant time and resources reporting quality measures. A previous study found that commercial health plans’ reporting measures have little overlap with each other or public plans. Finding a way to reduce physician burden is important for tracking purposes—and growing health plan and provider partnerships in commercial risk.

The organization

Cigna is a large national health plan that covers over 22 million lives. In 2008, they launched one of the first commercial accountable care models, the Cigna Collaborative Care program (CCC). Participating physician groups are incentivized through a shared risk arrangement if they meet market and national targets for improving quality and lowering costs. In 2023, the program contracted with 260 physician groups and covered 2.5 million commercial lives.

The approach

In 2016, Cigna redesigned their quality measures to reduce reporting burden for their partners. While these non-negotiable measures tend to remain the same year after year to promote continuity, new measures are carefully created through an extensive design and assessment process. Cigna’s team gets clinical input and feedback on measures through multiple cross-industry channels.

The result

Cigna reduced their number of quality measures from 101 to 17. Of the 260 physician groups in the CCC program, 98% adhere to each measure. Over time, they’ve significantly improved their performance, demonstrating network-wide quality improvement. Since its inception, Cigna Collaborative Care has helped lower annual costs, reduced ER visits, and improved gaps in care closure rates for their providers.