Combining Medical, Pharmacy and Behavioral Benefits Delivers Annual Savings of More than $850 per Customer with an Identified Health Improvement Opportunity

Publisher: The Insight Partners

By supporting the whole person, mind and body, with a connected set of medical, pharmacy, and behavioral benefits, employers can deliver better health and financial outcomes for those who receive coverage, according to Cigna's fourth annual Value of Integration study released today. These findings are based on a two-year analysis of more than 2.3 million claims from Cigna customers who receive coverage through their employer.

Delivering greater affordability in medical costs

The study found that employers offering triple-integrated benefits – medical, pharmacy and comprehensive behavioral – continue to see meaningful savings in total medical costs as compared to those with medical and basic behavioral coverage. On average, those with fully integrated benefits in the 2019 study:

• Saved $207 annually per customer and $867 annually per individual with an identified health improvement opportunity (about 16 percent of the population).
• Saw annual medical cost savings of $7,372 for individuals with conditions requiring a specialty medication, such as multiple sclerosis or rheumatoid arthritis.
• Showed savings of more than $11,679 for customers with an oncology diagnosis and 24 percent lower oncology in-patient costs.

"More than ever, employers are prioritizing whole person health and offering fully connected benefits, which are key to attracting and retaining talent," said Matt Totterdale, Senior Vice President Cigna Pharmacy. "Cigna offers tools such as our Cigna One Guide® solution, which gives us access to real-time data, predictive analytics and a complete picture of an individual's health. With this tool, we can put actionable information in the hands of health coaches, doctors, pharmacists, behavioral clinicians and other health care professionals to create personalized, coordinated interventions that enable better quality care, at the right time, in the setting that's best for the customer."

Increasing engagement and improving outcomes

With connected medical, pharmacy, and behavioral health benefits customers are more engaged in their health and well-being, are more likely to stay in-network for their care and are more informed about their care options, which can not only drive down costs but also often translate to improved outcomes. On average, the 2019 study showed:

• A 17 percent higher customer engagement in Cigna programs, such as counseling for conditions like diabetes and heart disease; lifestyle or wellness coaching to help with weight management and smoking cessation; and personal case management for more complex conditions like rheumatoid arthritis or cancer.
• Thirty-two percent lower mental health readmission rates, and 18 percent fewer out-of-network behavioral claims.
• Five percent higher utilization of in-network high-performing providers and four percent lower out-of-network claims.
• Improved outcomes for individuals in need of treatment for opioid misuse– with a 15 percent higher rate of receiving misuse treatment and 30 percent reduction in subsequent overdoses when experienced one year prior.

"We mobilize across the continuum of care – eliminating gaps in care, getting ahead of disease, and driving interventions with customers and providers that guide their next best actions," said Totterdale. "This ultimately makes it easier for customers to understand their health care choices and helps protect against surprise costs. Our integrated approach maximizes every opportunity to deliver a health care experience that is affordable, predictable and simple."