Archived Content

Driving Innovation In the Health Care Marketplace:

A CEO Report

CIGNA Corporation

Cigna’s mission is to improve the health, well-being and sense of security of those we serve.

Key to this mission is our belief that individuals deserve access to affordable health care. A sustainable system starts with individual accountability for lifestyle and behavior decisions that maximize personal health and productivity. When care is needed, high-value alternatives should be pursued. When care is delivered, caregivers should be paid based on the value, rather than the volume, of services provided.

For Cigna, this mission begins at home with our own employees. Cigna offers a full suite of programs that put our employees in charge of their health, with incentives and support to make it easier to stay or get healthy. A review of our population’s health and cost drivers focused our program innovation on chronic condition management, stress management and promoting access to quality, value-based care delivery.

In 2013, Cigna embarked on an initiative to establish five onsite clinics as a central part of our health care delivery system. Our goal was to transform our onsite centers from a focus on acute care to prevention and wellness targeting employees with chronic conditions. The results are promising: a comparison of 2012 and 2013 claim data shows an 81 percent increase in preventative visits, over 2,000 referrals into clinic programs and an estimated $240,000 saved as a result of closing gaps in care. Our experience produced valuable insights on factors to consider when designing effective onsite programs, such as local culture and dietary norms, geographical factors (prevalence of pollen, air quality) and the nature of work functions (production versus professional).

In a recent employee survey, we learned that 66 percent of employees feel stressed. We wanted to understand how stress impacted benefit costs and productivity, and we needed information to focus our improvement efforts. We developed a Total Stress Score measuring the impact of stress on total incidence (Integrated Personal Health Team [health risk assessment/self report] incidence, Cigna behavior health incidence and short-term disability [STD] incidence), total financial spend (total medical cost and total stress-related STD payout) and total productivity loss (total STD and family medical leave durations). Cigna used this score to differentiate stress levels among 12 of our largest worksites with a comprehensive view on prevalence and financial and productivity impacts. Actions are underway to study the top and bottom three sites to guide improvement initiatives.

Partnering with physicians to adopt models that reward higher-value care is core to making high-quality, affordable health care a reality in the United States. Cigna has been at the forefront of this movement and currently has collaborative models spanning 27 states, reaching more than 1.3 million customers. Results are encouraging. Our most seasoned groups with at least three years of experience average 3 percent better than market in total medical cost and quality measures.


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BRT companies provide health coverage to more than 40 million Americans. We help American workers and their families remain healthy, receive quality treatment when necessary and achieve better health outcomes. The private-sector innovations in the insurance marketplace that enable us to provide these services to our employees and their families serve as models for public programs — but additional reforms are necessary.

This report highlights the innovations we have made and the public policy changes we believe would drive value by promoting health and improving outcomes.