BLOOMFIELD, Conn.--(BUSINESS WIRE)--The nation’s health care system is moving from volume to value, yet it remains fragmented and complex. Health care providers are facing increased pressure to move from fee-for-service to value-based payment, yet current market solutions to accelerate this journey have been criticized as too rigid to meet complex provider needs. Cigna (NYSE: CI) has partnered with health care providers for many years to help them align their financial incentives with patient health outcomes, resulting in joint success through shared risk.
Cigna is now assembling assets, resources and talent from across the enterprise to create a new service company that will work closely with more provider organizations of all types to help them focus on improved patient outcomes and achieve better health care quality and affordability for the populations they serve.
The new company, CareAllies, Inc., will deliver the systems, capabilities and management services that providers need to be successful under a variety of value-based and risk-sharing models across the value-based reimbursement spectrum. CareAllies will offer services to help ease providers’ administrative burden across payers and can even help providers launch and manage their own health plans.
The new CareAllies will combine assets from Cigna, Cigna-HealthSpring’s management services division for independent physician associations (IPAs), and QualCare Alliance Networks, Inc. (QANI), which Cigna acquired in 2015. It will leverage these companies’ extensive histories of successful and innovative provider collaborations. Dr. Julian Harris has been named president of CareAllies, Inc., which will operate as a wholly-owned subsidiary of Cigna.
“Our aim is to enable all of our provider clients to succeed in an extremely competitive and disruptive health care environment,” Harris said. “Whether a provider’s business is focused on commercial, Medicare, or Medicaid patients, the new CareAllies has the know-how and patient health engagement experience to help deliver better quality and financial outcomes as providers navigate the transition to value-based payment.”
CareAllies will focus on advisory and management services, technology, and analytics, which are all fundamental to transforming physician practices and delivery systems as they move from volume to value. Not all providers will need the full suite of services, however.
“We will meet provider organizations where they are with the services and capabilities they need,” Harris said. “Some will need us to provide or build core capabilities, and we will also work collaboratively with provider clients that already have those capabilities in place to help them achieve greater physician alignment and clinical integration.”
Cigna has been a leader in the accountable care organization (ACO) and volume-to-value movements since 2008 and now has 150 Cigna Collaborative Care arrangements with large physician practices. Earlier this year, Cigna started a joint venture arrangement with St. Joseph Hoag Health to offer HMO and exclusive provider organization (EPO) plans in Orange County, Calif. Through another joint venture agreement, Cigna is collaborating with Seton Health Plan to introduce a group health plan in Austin and Waco, Texas.
Cigna-HealthSpring, which Cigna acquired in 2012, is a leader in helping doctors participate in value-based care and has management agreements with more than 40 IPAs. It helps prepare them not only to share the incentives they earn for delivering better care at a lower cost, but also to assume greater financial risk while improving patient health outcomes across a variety of products and payers.
For nearly 25 years, QANI has worked with and for hospitals, physicians and health systems through the development of private-label, multi-tiered health plans for both the commercial and Medicare markets. Its modular, plug-and-play operating platform helps providers evolve their practice and business models to meet local market needs, and its analytic tools support providers as they transition to value-based care.
The establishment of the new CareAllies will enable these and other collaborations with a variety of health care provider organization types at varying levels of organizational maturity.
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. For more information about CareAllies, Inc., visit www.careallies.com.