As part of a contract extension with Tenet Healthcare, Cigna has established a first of its kind quality-based reimbursement agreement.
The deal extends in-network access for Cigna's commercial and HealthSpring Medicare Advantage members at Tenet's 77 hospitals and 190 outpatient centers in 15 states, mostly in the south, southwest and midwest, including Illinois, Texas and Florida.
It also represents Cigna's first pay-for-quality contract with a health system. The arrangement "rewards Tenet hospitals for improved quality of care and cost efficiency, which, for the first year, will be based on national quality measures established by the Centers for Medicare & Medicaid Services," the companies said.
Financial terms and other details were not disclosed, but the companies said the contract will follow the model of Cigna's Collaborative Care program, an incentive-based payment initiative used with medical groups to manage chronic care and avoid unnecessary high-cost treatment -- a type of payer-provider agreement that Cigna CEO David Cordani has described as "risk aligned."
The deal comes as Tenet is trying to achieve new clinical and financial synergies through its recent acquisition of Vanguard Health Systems, which added 28 new hospitals and several dozen free-standing facilities and expanded its range to Michigan, Illinois, Arizona, Massachusetts and created new venues in Texas.
"We are pleased that this agreement provides Cigna customers access to our entire network of quality healthcare services," said Clint Hailey, chief managed care officer at Tenet Healthcare, in a media release.
"Cigna is one of our largest and most important payer relationships. This agreement provides multi-year coverage stability for their customers, and we look forward to continuing our collaboration to improve quality outcomes and cost effectiveness," Haley said.
"We're pleased that we were able to reach an agreement with Tenet that's in the best interests of our clients and customers and that will enable our customers to receive high-quality care at Tenet hospitals and other facilities without interruption," said John Wray, Cigna's senior vice president for network contracting and delivery system collaborations. "We look forward to working in partnership with Tenet over the next several years to help our customers improve their health and well-being."