The Evernorth^® Behavioral Health (Evernorth) Centers of Excellence (COE) program is designed to meet the growing customer demand for information about patient outcomes (quality) and cost efficiency for our in-network mental health, substance use disorder, and eating disorder treatment facilities.

We evaluate patient outcome and cost-efficiency scores to determine if a facility has met criteria to receive a COE designation.

Patient outcomes score

The patient outcomes score is a quality measure of a facility’s relative effectiveness in treating mental health, substance use disorders, or eating disorders. It is based on the following quality measures:

• Readmission rates
• Seven-day ambulatory follow up
• Discharge to an in-network provider

Cost-efficiency score

The cost-efficiency score is a measure of a facility’s average cost to treat mental health, a substance use disorder, or an eating disorder, and is based on the facility’s fee schedule and average length-of-stay data. It does not include provider fees or outpatient services, and is severity adjusted for comparison. The score reflects the rates that a facility charges, as well as the average time spent in the facility for the specific treatment. A variety of factors, including geographic cost differences, may affect the overall score.

Star displays

A facility can receive a score of up to three stars (*), for both patient outcomes and cost efficiency, for each evaluated condition. Those that attain at least five stars (three stars for patient outcomes and two stars for cost efficiency, or three stars for cost efficiency and two stars for patient outcomes) receive the Evernorth Behavioral Health COE designation.

Additional information

As we continue to expand nationwide access to our behavioral COE programs, you may have more referral options^* for your patients who need inpatient treatment for mental health, substance use disorders, or eating disorders.

To find an Evernorth Behavioral Health COE facility in your area, call the telephone number on the back of your patient’s ID card.  You can also visit Cigna.com > Find a Doctor to search for a facility using the COE designation. Your patients can also locate COE facilities by logging in to myCigna.com for Cigna Healthcare^℠ customers or well.evernorth.com for Evernorth customers.

Future COE updates

Please note that over the next year we will evolve our patient outcomes to ensure they align with our clinical framework. In the future, Evernorth will establish thresholds for critical quality metrics. For example, a minimum score will be required for the seven-day ambulatory follow up. In the next 12 months, we will actively engage providers to strengthen ambulatory follow up through tools and resources.

Additionally, we look forward to expanding the COE designation to additional programs and services. We are actively considering an opportunity for a designation for Medication Assisted Treatment (MAT) among other treatment modalities and populations of focus. Evernorth will contact providers for more information about specialty programming.

^*   The Evernorth Behavioral Health Centers of Excellence (COE) program reflects only a partial assessment of quality and cost efficiency for select facilities. Therefore, it should not be the sole factor used when you or your patients make decisions about where they should receive care. We encourage individuals to consider all relevant factors and to speak with their treating physician when selecting a facility.