Insurer's Reimbursement Model Rewards Lower Costs

Rene Letourneau, for HealthLeaders Media , July 8, 2013

The CAC initiative began in 2008 with Dartmouth-Hitchcock Health, an academic, integrated delivery system based in Lebanon, NH, and one of the ten groups participating in the CMS Physician Group Practice Demonstration project. 

Prior to 2008, Dartmouth-Hitchcock was already working with Cigna to restructure its reimbursement model, says Lynn M. Guillette director, payer contracting & ACO relationships. 

"We were working with Cigna to implement changes designed to improve care and align financial rewards with clinical outcomes. We saw the opportunity to pilot Cigna's Collaborative Accountable Care initiative as a way to further advance our goal to transform the healthcare delivery system while also transforming the healthcare payment model."

"We wanted to be able to test out concepts being applied in the Medicare patient population to a commercial sector patient population," she adds. "Our vision is to achieve the healthiest population possible, leading the transformation of healthcare in our region and setting the standard for our nation. Participating in and helping to design Cigna's Collaborative Accountable Care initiative aligned with our mission and vision for creating a sustainable healthcare system."

For the 2011-2012 performance period, Dartmouth-Hitchcock's actual total medical cost per member per month decreased by 2.2% over the prior year period, Guillette reports.

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