Cigna Transition to Value-Based Health Care Resulted in $600 Million in Medical Cost Savings

In 2015, Cigna accelerated the transition to alternative payment models that linked health care provider payments to both quality and affordability. The goal was to have 50% of U.S. Medicare and commercial health care provider payments made through alternative payment arrangements by the end of 2018. We're happy to report that we've exceeded this goal in our top 40 markets, proving that value-based care is a successful solution¹.

Cigna launched value-based care delivery a decade ago. We embraced a health care delivery system that pays health care providers based on improved health outcomes instead of the traditional fee-for-service model, which pays providers based on volume. The move helped us shift 50.5% of provider payments in our top 40 markets¹ to alternative payment arrangements, and improve the quality of health care for customers. The results were impressive: more than $600 million from 2013-2017¹. In addition, value-based care has contributed to Cigna maintaining the lowest medical cost trend among our top national competitors for six consecutive years².

“Cigna's focus on quality and affordability enabled the company to exceed its 50 percent alternative payment goal in our top 40 markets, offering more value for our customers’ and clients’ health care dollars,” Scott Josephs, MD, chief medical officer at Cigna, explains. “This is a critical milestone as we work to accelerate the pace of change in health care delivery in the United States. Our commitment to value-based care and alternative payment models is driving better health outcomes, increased affordability and improved patient experience for the people we serve.” 

The numbers tell the story.

• More than 3.6 million Cigna commercial customers access value-based care through 240+ primary care provider organizations, 500+ hospital facilities and 270+ specialist programs in six disciplines, including 245+ Episodes of Care programs³.
• 96% of Cigna customers in the company’s top 40 markets are within 15 miles of at least three participating primary care providers⁴.
• 85% of Cigna Medicare Advantage customers access care through value-based arrangements².

Value-based care drives improved quality.

Cigna's transition to value-based care models has resulted in significant improvements in health care for its customers. Top-performing Accountable Care Program health care providers demonstrated a quality performance of 11% better than the market⁵ - with 92% of providers either meeting or exceeding quality benchmarks⁶.

Cigna collaborates with participating providers who receive clinical support, data and insights that help improve health outcomes based on an individual's unique health care needs.

According to a survey⁷ of Cigna commercial Accountable Care Program providers:

• 92% say the insights and guidance Cigna provides help them improve performance and outcomes.
• 95% say their relationship with Cigna is collaborative and consultative rather than transactional.
• 95% say it's easy to do business with Cigna.

Learn more here.

1. Cigna January 2019 analysis of national Accountable Care program groups with effective dates from 2013 through 2017. Reimbursements already paid to groups are subtracted from the savings to reflect overall investment.
2. Medical cost trends publicly reported by CI, AET, ANTM and UNH for 2013 through 2018.
3. Cigna internal analysis of existing arrangements as of December 2018.
4. Cigna August 2018 analysis of national medical book of business customers in the top 45 US markets, defined by market size, within 15-mile zip code radius (zip code to zip code distance of provider main office location) of three Accountable Care program physicians. Subject to change.
5. Cigna June 2018 analysis (weighted average) of top five national Accountable Care program groups per metric compared to local market in 2017. Accounts for 23,405 aligned customers. Comparisons to market are established using Cigna internal claims data.
6. Cigna June 2018 analysis of 2017 data of Accountable Care program groups nationally active at least one year.
7. Cigna Accountable Care Organization (ACO) Experience Survey, September 2017.