Kaiser Permanente has negotiated its first partnership to make use of a rival insurer’s business community, starting in August.
Below the five-year settlement introduced Tuesday, Kaiser’s greater than 9 million members looking for emergency care whereas touring exterior the eight states served by the Oakland, California-based system can go to suppliers contracted with Cigna. Kaiser members shall be liable for the usual cost-sharing related to their plan quite than paying out-of-network advantages.
When Kaiser sufferers go to Cigna suppliers, their payments shall be routed via Cigna’s Evernorth healthcare providers division, a spokesperson mentioned. The deal is meant to decrease affected person prices, streamline administrative providers and improve healthcare entry.
A Kaiser spokesperson declined to reveal phrases of the deal. The settlement doesn’t apply to Kaiser’s Medicare and Medicaid enrollees.
It is not the primary time Cigna has made its PPO out there to rivals. In 2020, Cigna partnered with insurtech Oscar Well being to launch a collectively branded plan for small employers in California. The Cigna+Oscar plan depends on Cigna’s supplier community and competes with Kaiser.
As a part of the Kaiser settlement, Cigna’s Accredo specialty pharmacy service will develop into its most well-liked pharmacy for sure, restricted distribution medicine, similar to Cayston, Kalydeco and Symdeko, all of that are used to deal with cystic fibrosis, the spokesperson mentioned. Specialty product distributor CuraScript SD shall be Kaiser’s most well-liked provider for different specialty merchandise.
Each Accredo and CuraScript SD are operated underneath Cigna’s Evernorth arm.