Cigna Accountable Care Program - New Haven Community Medical Group

Program Location: 
New Haven, CT
Number of Practices: 
Payer Type: 
Partner Organizations: 
New Haven Community Medical Group

Reported Outcomes


In October 2012, Cigna and the New Haven Community Medical Group, launched an accountable care organization (ACO) pilot program to expand patient access to health care, improve care coordination, and achieve the “triple aim” of improved health outcomes (quality), cost effective care and increased patient satisfaction. The program will benefit nearly 18,000 individuals covered by a Cigna health plan who receive care from among New Haven Community Medical Group’s 583 physicians, including 216 primary care doctors and 367 specialists. The New Haven Community Medical Group is an integrated network of physicians and other health care professionals that works in clinical collaboration with the Yale-New Haven Hospital.  Under the program, New Haven Community Medical Group doctors monitor and coordinate many aspects of an individual’s medical care. Patients will continue to go to their current physician and automatically receive benefits of the pilot program.  The program is expected to provide immediate benefits for those who need help managing chronic conditions such as diabetes or heart disease. 

Critical to the program’s benefits are care coordinators, employed by the medical group, who help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between the medical group and Cigna that ultimately results in a better experience for the individual.  The care coordinators will enhance care by using patient-specific data from Cigna to help identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators are part of the physician-led care team that helps patients get the follow-up care or screenings they need, identifies potential complications related to medications and helps prevent chronic conditions from worsening.  Care coordinators can also help patients schedule appointments, provide health education and refer patients to Cigna's clinical programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.

Payment Model: 

Cigna will compensate the New Haven Community Medical Group for the medical and care coordination services it provides. Additionally, the medical group may be rewarded through a “pay for performance” structure if it meets targets for improving quality and lowering medical costs.

Fewer ED / Hospital Visits: 

Cigna press release (May 2015)

  • 23% reduction in avoidable ER visits per thousand
  • 10% reduction in ER visits
  • 12% reduction in ER visits  “frequent users” 
Improved Health: 

Cigna press release (May 2015)

  • success rate with evidence-based medicine guidelines is better than market at 85.3 percent.
  • treatment of high cholesterol at 2 percent better than market and epilepsy at 15 percent better than market.
  • 96 percent of diabetes patients have the HbA1c (blood sugar) test. 
Cost Savings: 

Cigna press release (May 2015)

  • total medical cost is trending 1.9 percent better than market 
  • use of scans per thousand is trending 12 percent better than market
  • advanced imaging cost has decreased 14 percent
Last updated August 2015
Go to top