Chicago-based Rush Health has signed a deal with insurance and health services organization Cigna that will pay physicians to enhance patient care while spending less money. The deal will entail a financial bonus from Cigna if Rush can meet certain quality standards and cut costs while doing so. This will be challenging because keeping track of patients racking up unnecessary ER mileage or making sure medications are taken on schedule is no easy task.
In addition to the financial incentive, Rush will benefit from an enviable peek into Cigna's considerable data on patient behavior and why care is sought outside the network. This perk is especially important in light of the focus by insurers on preventive care where healthcare organizations are paid to keep people healthy or lose money if they fail to do so. The President and CEO of Rush Health, Brent Estes, feels access to this Cigna data is of substantial advantage to Rush.
The Rush-Cigna deal that came into effect on April 1 will cover the more than 4,000 patients who are insured by Cigna and who obtain most of their primary care from the approximately 1,400 physicians at one of Rush Health's four hospitals in the Chicago area, including the anchor hospital, Rush University Medical Center.
This deal between health provider and insurer is the sixth of its kind in the Chicago area alone, and the model is gaining steam around the nation. The strategy is not limited to Illinois alone: in Bloomfield, Connecticut, an insurer has put 150 such deals in place since 2008. Cigna will gain an edge over its rivals if it can demonstrate to health systems that keeping patients out of the hospital is a major cost-saving strategy.
Dr. Peter McCauley, Sr., who heads Cigna's operations in the Midwest, reiterates the savings that clients can expect from this deal. By his estimate, Cigna Collaborative Care, the name the program goes by, has already saved close to $50 million in the past 3 to 4 years nationwide due to better preventive care and follow-up.
The deal is an example of value-based services and healthcare organizations moving toward entering into contracts with insurers that are based on the quality of care delivered as opposed to the number of tests and services performed. The Rush-Cigna deal is expected to not only enhance patient care, but also save money in an increasingly cost-conscious healthcare environment.
