Under the program, HeartWell providers will receive payments for serving Cigna policyholders, with eligibility to earn shared savings if certain quality targets are met and the episode of care is below a risk-adjusted cost. An episode of care includes pre-care, cardiovascular procedures, medications, recovery and follow-up care through 12 months after the procedure.
Additionally, quality targets include lowering hospital readmissions and post-surgery complications like blood clots, pulmonary embolisms and infections.
The value-based program is part of Cigna Collaborative Care, a model using incentives to encourage providers to improve health while cutting costs. It is Cigna’s first chronic episodes-of-care payment model for cardiology.
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