January 1, 2025
January 2025
In case you missed them, here is a recap of and links to all of the U.S. commercial articles that were published in the Provider Newsroom in January.
Cigna Healthcare disaster support
(January 30, 2025) When disaster strikes, Cigna Healthcare® stands ready in its commitment to offer additional support to help you and your patients maintain uninterrupted access to health care, navigate challenging times, and restore normalcy. Our Disaster Resource Center is home to a variety of resources for your patients and their families, regardless of insurance carrier, to help them manage the unexpected and care for their well-being.
(January 24, 2025) Dr. Scott Joseph is retiring after nearly 25 years with Cigna Healthcare and welcomes Dr. Amy Flaster as the new Chief Medical Officer of Cigna Healthcare.
Evernorth Behavioral Health Centers of Excellence program
(January 24, 2025) The Evernorth® Behavioral Health Centers of Excellence (COE) program is designed to meet the growing customer demand for information about patient outcomes (quality) and cost efficiency for 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.
Advancing clinical excellence through value-based reimbursement in behavioral health
(January 23, 2025) Basing payment on clinical outcomes rather than the volume of service is increasingly common among medical practitioners, yet value-based reimbursement is less common among behavioral health practices. In a new paper published in The Journal of Mental Health Policy and Economics, “Has Value-Based Reimbursement Arrived for Behavioral Health? A Payer Perspective,” five experts from The Cigna Group® outline the advantages and challenges of making value-based reimbursement arrangements the norm for behavioral health.
Coverage Confirmation Grid: Use it to verify coverage, benefits, and your network status
(January 17, 2025) To help providers save time and ease their administrative burden, Evernorth® Behavioral Health has created a Coverage Confirmation Grid (an Excel spreadsheet). This is a fast and simple way for you to request the most frequently needed information regarding your patients, such as verifying general benefits and eligibility, whether a specific provider is in-network, prior authorization requirements, and accumulation information.
Important reminders for the new year
(January 17, 2025) As many benefit plans change at the beginning of the year, we recommend that you confirm a patient’s benefits, eligibility, and any financial responsibility at their first visit of the new calendar year with you. The secure Evernorth portal (Provider.Evernorth.com) gives you 24/7 access to this information and more.
HEDIS and QRS data collection are right around the corner
(January 16, 2025) Each year, we collect data for the Healthcare Effectiveness Data and Information Set (HEDIS®). The National Committee for Quality Assurance (NCQA), employers, and health plans developed HEDIS as an industry-wide method to help compare and assess a health plan’s performance in a variety of areas. HEDIS, along with the Centers for Medicare & Medicaid Services (CMS) Quality Rating System (QRS), measures and reports clinical effectiveness results of our medical plans for significant public health issues such as cancer, heart disease, smoking, asthma, and diabetes.
(January 14, 2025) Traditionally, the standard treatment for locally advanced rectal cancer has been neoadjuvant chemotherapy and radiation followed by surgical resection of the rectum. Recently, however, research published in the New England Journal of Medicine and the Journal of Clinical Oncology demonstrated that for stage 2 and 3 rectal cancers, including metastatic, it is possible patients may benefit from immunotherapy, a less intensive approach, when indicated by biomarker testing.
Support for customers and health care providers in Southern California in the wake of wildfires
(January 10, 2025) To ensure providers in California and their patients receive the support they may need while coping with the tragic wildfires, Evernorth® Behavioral Health and Cigna Healthcare® are taking several steps to give access to needed care as easily as possible in Los Angeles and Ventura counties.
Helping you find the appropriate resource
(January 13, 2025) Evernorth® Behavioral Health developed a flyer that provides guidance on when to visit its provider portal, when to call Provider Services, and when to contact a Provider Relations representative. By using the appropriate resource to engage us, we can provide you with the best possible service.
A message to behavioral health professionals this Mental Health Awareness Month
(January 7, 2025) During Mental Health Awareness Week (May 12–18) — and throughout the month of May — we come together to continue the conversation around mental health, reduce stigma, and encourage people to care for their emotional well-being. It is also a meaningful time to recognize the deep and lasting impact of behavioral health professionals.
Behavioral health and medication adherence in primary care guide
(January 1, 2025) Incorporating behavioral health interventions into primary care can improve treatment adherence, chronic disease management, and overall patient outcomes, while promoting the efficient delivery of whole person care in a meaningful way. To support providers in their efforts to integrate behavioral health with primary care, Cigna Healthcare® recently released a guide that explores the most common behavioral diagnoses treated in primary care and strategies to encourage medication adherence.
Cigna Healthcare Medicare Advantage – Enhanced benefits for 2025
(January 1, 2025) In 2025, Cigna Healthcare® Medicare Advantage will offer strong medically focused plans with competitive cost-sharing benefits to support preventive health and chronic condition management, as well as reduce health disparities. Benefits may vary according to plan and location.
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