Distinguishes network doctors who practice in one of the specialties reviewed and who meet certain quality and cost- efficiency measures. If you have CCD coverage, "CIGNA Care Network" and the CCD logo will be printed on your CIGNA ID card. When you receive covered services from a CIGNA Care Designation specialist, you receive the in-network coverage level and your copayments or level of coinsurance may be lower. To qualify for this designation, doctors must be board certified in their specialty and have earned one or more independent ratings. Learn more about the Cigna Care Designation.
Cost efficiency score reflects both the patient care and cost for the doctor, compared to their specialty peers in their market. This measurement uses medical costs (inpatient, outpatient, lab, radiology, drugs, etc.) to establish an average "episode of care" (a set of medical services over a period of time that are related to one illness or condition) that's also adjusted to help account for differences in the severity of patients' illnesses.
This quality rating should not be used to make final decisions about a doctor or doctor's group.
Doctor is in approximately the top tier of practices within their geographic market for use of evidence based medicine. Measuring adherence to Evidence Based Medicine (EBM) standards can illustrate how well a doctor uses recommended medical guidelines for treating chronic diseases and providing preventive care.
Cigna evaluates the quality of doctor care using measurement rules developed by the National Quality Forum (NQF), Ambulatory Care Quality Alliance (AQA), Healthcare Effectiveness Data Information Set (HEDIS), or evidence based standards developed by independent physician organizations (such as the American College of Physicians, the American College of Cardiology, or the American Diabetes Association). These rules span 38 disease and preventive care conditions.
Board certification demonstrates a doctor's exceptional knowledge, experience and skills in a particular specialty and/or subspecialty of medical practice as determined by the American Board of Medical Specialties (ABMS).
Board certified doctors are focused on improving patient outcomes and providing responsive patient-centered care. Patients, doctors, health care professionals of all kinds, insurers and quality organizations look for this designation.
To maintain board certification, a doctor participates in an extensive process that involves completing accredited education, specialty training and periodic oral and written exams to demonstrate competency. You may check the doctor's board certification status at the American Board of Medical Specialties (ABMS) website.
Awards or recognitions that come from experts in the medical industry and indicate the doctor provides excellent patient- centered care in one or more of the following areas: diabetes, heart and stroke, back pain, use of technology for improved patient care, or commitment to comprehensive treatment approaches that involve other doctors, specialists and the patient's family.
The clinicians identified herein have been recognized under the National Committee for Quality Assurance's (NCQA) Heart/Stroke Recognition Program (HSRP), Diabetes Recognition Program (DRP), Back Pain Recognition Program (BPRP), Physician Practice Connections®-Patient Centered Medical HomeTM, Physician Practice Connections®, Patient- Centered Medical HomeTM 2011 (PCMHTM 2011), and Patient-Centered Specialty PracticeTM (PCSPTM). NCQA Recognition is not a guarantee that individual medical care delivered by a clinician or practice will meet a certain standard of care. NCQA MAKES NO REPRESENTATIONS, WARRANTIES, OR ENDORSEMENT ABOUT THE QUALITY OF ANY CLINICIAN OR PRACTICE THAT MAY HAVE ACHIEVED RECOGNITION.
Visit the NCQA website to learn more about these recognition programs.