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 maintains a goal of 80% for the outpatient Treatment Records of contracted network professionals that are reviewed annually for documented efforts to coordinate care with the Primary Care Physician, in the presence of customer consent. Of Cigna's network professionals who responded to our 2013 annual survey, 86% reported care coordination with Primary Care Physicians or other medical professionals for individuals in their care. Customer concern with confidentiality is cited as the reason communication does not occur for those cases where a Primary Care Physician has been identified. Cigna's 2013 review of contracted behavioral professionals’ treatment records sought documented evidence for “attempts to coordinate behavioral care with the PCP or other relevant medical professionals at any time during treatment when coordination of care is indicated.” The 2013 resulting score of 79% for the treatment record review did not meet Cigna’s 80% goal, and was statistically unchanged from our 2012 network treatment record review.

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 the Quality Management section and in Appendix G of our Medical Management Program Guide.