Cigna’s Integrated Health Plan Reduced Care Costs for Employers

Employers saved more than $1,400 per member per year when employees enrolled in Cigna’s integrated health plan that coordinates medical, pharmacy, and behavioral benefits, according to a study from the payer.

The research builds on the global professional services firm Aon’s Value of Integration Study, which found that Cigna’s integrated employer clients saved $148 per member per year in 2021.

Cigna used a match case-control method to evaluate the impact on employees who participated in health improvement programs and served members with comorbidities.

Cigna’s integrated health plan provides employers and members access to integrated medical, prescription drug, and behavioral health benefits.

The payer found that the integrated benefit has helped save employers over $1,400 per member each year.

“Integrated benefits provide a real-time, connected platform that enables us to anticipate our customers’ unique health needs and support them as they make important health care decisions – driving lower costs over time,” Katy Wong, chief pharmacy officer of Cigna Pharmacy, said in the press release.

“There is tremendous value for employers in having this holistic view across the continuum of care for their workforce. It produces significant savings on healthcare, which they can pass along to their employees, and it also improves the health of their workforce, which fuels productivity and business growth.”

The savings were higher among members with certain high-cost conditions who required specialty medicines. For example, employers saved nearly $9,000 per member annually when members needed specialty drugs. The savings increased to over $11,000 per member when the specialty drug was for an inflammatory condition such as rheumatoid arthritis.

When members who took specialty drugs and had a confirmed depression diagnosis enrolled in the triple-integrated health plan, employers saved almost $17,500 per member.

The integrated plan also helped minimize the cost of chronic conditions. Employers saved nearly $400 per year for members with a musculoskeletal diagnosis and over $1,400 per year when a member with a musculoskeletal diagnosis engaged with a health coach.

The savings increased to $2,500 per member per year for individuals with a diabetes diagnosis.

Over 60 percent of US adults have a chronic disease, the payer noted. In addition, chronic diseases are one of the main drivers of the country’s $4.1 trillion annual healthcare costs.

Members enrolled in Cigna’s triple-integrated plan had fewer emergency room visits and less expensive invasive inpatient procedures. For example, members with diabetes had a 17 percent lower rate of avoidable emergency room visits, while members with musculoskeletal conditions had a 133 percent lower rate of surgeries in an inpatient setting.

Additionally, members with musculoskeletal conditions had 26 percent fewer opioid overdoses and 16 percent fewer interventional procedures, including injections and biopsies.

Cigna recently launched Cigna Pathwell, which uses analytics, clinical expertise, treatment planning, and digital solutions in its health services business, Evernorth. The product integrates these tools with Cigna’s medical, pharmacy, and behavioral health benefits management and provider networks to deliver personalized care to patients with high-cost, complex health conditions.

Integrating different types of care can help improve patient experiences and lower healthcare costs. AHIP encouraged providers and policymakers to join payers in integrating physical and behavioral healthcare.

Shifting to value-based payment models, including integrated behavioral healthcare in medical education, and supporting interoperability efforts are critical ways stakeholders can advance integrated care.