Continuity and Coordination of Behavioral and Medical Care

Cigna monitors the exchange of information between behavioral and medical health care professionals. Annually, behavioral practitioners are surveyed regarding the degree to which coordination with Primary Care Physicians occurs in the care they deliver to Cigna customers. Additionally, Cigna reviews outpatient Treatment Records of contracted network professionals for documented efforts to coordinate care with the Primary Care Physician, in the presence of customer consent.

In 2011, 86% of all surveyed professionals report care coordination with Primary Care Physicians. Customer concern with confidentiality is cited for 99% of those cases in which it does not occur. 2011 record review sought documented evidence for “attempts to coordinate behavioral care with the PCP at any time during treatment when coordination of care is indicated.” The 2011 resulting score of 66% did not meet the 80% goal, and was lower than 2010 performance of 69.5%.

Cigna encourages consideration of appropriate coordination of medical and behavioral care for all customers. This is particularly important to improving the overall healthcare for individuals with co-morbid medical and behavioral conditions. As a behavioral network professional, you may find it helpful to review Cigna’s guidelines and helpful tools for coordination of medical and behavioral care. They can be found in section 5 and Appendix G of our Medical Management Program Guide.

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