Cigna Expands Value-Based, In-Home Primary Care Services in Medicare Advantage

Cigna has formed a value-based care partnership with an in-home primary care organization in order to improve quality of care and access to care for Medicare Advantage member, the partners announced.

Cigna’s partner, Heal, has conducted over 275,000 visits through telehealth, remote monitoring, and in-home care in eight states.

“Cigna aims to improve all aspects of our customer's health and well-being, and providing in-network coverage for quality, affordable, and convenient health care is one way we do this,” J.B. Sobel, MD, chief medical officer of Cigna Medicare, said in the press release. “I have no doubt Heal will provide our Medicare customers with the highest quality care in the comfort of their home.”

The partnership will enable Cigna Medicare Advantage members in Georgia, Illinois, North Carolina, and South Carolina to access in-home primary care services.

Executives involved in the partnership noted that the value-based care agreement will empower chronic disease management and preventive care for Cigna Medicare Advantage members in the service areas, according to the press release.

The model that Cigna’s new partner employs has demonstrated the potential to improve Medicare spending for chronic disease management.

The partnership went into effect immediately when the announcement was released on October 27, 2022.

In-home primary care has demonstrated the capacity to improve patient satisfaction in addition to decreasing healthcare spending.

In-home primary care is distinct from traditional home health care in a couple of ways. Traditional home healthcare largely consists of post-discharge care or rehabilitation, whereas in-home primary care encompasses routine primary care services. In-home primary care can also act as a wraparound service conducted alongside care that patients might receive in a provider office.

Primary care in general has been key to the success of value-based care efforts, a fact recognized by not only providers and health insurance companies but by their employer partners as well. In California, health insurers, employers, and providers have banded together around the principle that standardizing and unifying around advanced primary care is worth temporarily putting aside competitive interests in order to advance value-based care aims.

Cigna is not the only major payer to pursue home healthcare and to emphasize the importance of primary care services.

For more than a year, Humana has been on a journey of integrating its home healthcare program, Kindred at Home, into its overarching home healthcare brand, CenterWell Home Health. The payer has indicated that the reliance on home healthcare during the coronavirus pandemic was a major motivator for this strategy.