Cigna pharmacists help enrich collaborative care

Cigna pharmacists help enrich collaborative care

Cigna Collaborative Care™ (CCC) is one of Cigna’s overall efforts to encourage value-driven care. It involves healthcare providers who come together with a group of care collaborators to coordinate high-value healthcare services in exchange for value-based payment models. The shared goal is to improve health, while lowering total health care costs.

With each CCC arrangement, the participating provider’s office designates an embedded care coordinator (ECC). This person is typically a nurse, who serves as a guiding hand to walk with a customer through their health care journey. The ECC connects the customer with various support resources and tracks progress via an online dashboard, called iCollaborate. This tracked information is available to the health care provider as well as all other involved health care collaborators, including pharmacists. They work together to input and track metrics that can assist customers in successfully managing their health.

Pharmacists contribute specific information that helps spur results.
Our clinical pharmacists speak with ECCs and customers that have integrated medical and pharmacy benefits with Cigna. Pharmacists aim to improve medication adherence and close evidence-based clinical gaps in care that have a medication component. This can help control chronic conditions and reduce total cost of care.

Typical tasks Cigna pharmacists perform include:

  • Reviewing medication regimens. Pharmacists help to make sure customers are prescribed the right dose and treatment schedule to control their chronic condition and remain adherent to that regimen.
  • Making recommendations. Pharmacists may recommend adding a new therapy. They might also suggest ways to optimize an existing therapy. This could include recommendations to make the therapy more affordable. This could also include urging customer adherence to their prescribed medications and their provider visits.
  • Discussing potential side effects. Pharmacists also help to monitor for potential drug interactions.
  • Making connections with additional Cigna clinical support. Pharmacists review what support resources are available through the customer’s plan of benefits. They may refer to a dietician, case manager, or social worker, for example.

Customers with Cigna benefits have access to one of two levels of pharmacist support:

  • Cigna CoachRx pharmacist support: Any customer within a CCC arrangement that has a Cigna pharmacy benefit has access to a CoachRx pharmacist. There are no limitations and no buy-ups to access this support. It’s just part of the perks of being a customer with integrated medical and pharmacy benefits through Cigna. Typically, we refer customers directly to a CoachRx pharmacist. This referral comes from a Cigna Health Coach, Cigna Case Manager or ECC, for example. Follow up support is accessible via a designated phone number – 1-800-835-8981. CoachRx pharmacists may help support a customer for reasons like medication non-compliance, or a medication recommendation after a hospital discharge, for example.
  • Cigna Aligned pharmacist support: For an extra level of pharmacist support, many CCC provider groups have agreed to have a proactive targeted relationship via the Cigna Aligned Pharmacy Program. With this program, the CCC provider group has their own dedicated Cigna Aligned Pharmacist available. They examine evidenced-based designated quality measures and help to close identified gaps in care. Our Cigna Aligned Pharmacists also access iCollaborate to pull data around non-compliant customers and document notes for the ECC to view and respond to/collaborate on.

 When intervention occurs between a Cigna Aligned Pharmacist and an ECC, customers benefit.

  • 43% of those with diabetes and HbA1c over 8.0 moved to the targeted range.1
  • 36% of those with coronary artery disease not on a statin began taking one.1
  • 63% of customers not adherent to a statin became adherent.1

CCC arrangements work to meet providers at their current level of performance and help them reach their full potential. Pharmacists support this process by helping to create even more meaningful connections to support customers in managing their health.

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1. Accountable Care quality measurement data from January 1, 2020 through December 31, 2020.

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