Florida cardiology group, Cigna launches value-based episodes-of-care payment model
Cigna agreed to a value-based episodes-of-care payment model with HeartWell LLP, a medical practice with 23 cardiologists in nine offices in South Florida.
The arrangement, which was announced Jan. 25, is part of the Cigna Collaborative Care initiative that is modeled after accountable care organizations. Launched in 2008, Cigna Collaborative Care now has 160 arrangements with large physician groups in 29 states as well as arrangements with medical practices specializing in gastroenterology, obstetrics-gynecology, oncology and orthopedics.
The deal with HeartWell is Cigna’s first program for people diagnosed with chronic coronary artery disease. HeartWell will continue to receive payments for providing medical care to patients with Cigna insurance and will also be eligible to earn extra money if it meets certain quality and cost goals.
Cigna defines an episode of care as pre-care, cardiac procedures such as cardiac catheterizations and coronary angioplasty, medications, recovery and follow-up care through 12 months following the procedure. HeartWell will receive a portion of the savings if the costs of the episode of care are below the risk-adjusted expected cost and if it meets quality targets such as a reduction in hospital readmissions and post-surgery complications.
“At HeartWell, we believe in working closely with patients and their primary care physician to keep them healthy,” Jonathan Fialkow, MD, the group’s managing member, said in a news release. “We strive to help our patients live better lives through the high-quality care we provide. We are pleased to be the first cardiology group in the nation to partner with Cigna on this type of arrangement focused on the value of care rather than volume of care. We look forward to working collaboratively on this initiative to improve the quality and affordability of care.”
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.