Cigna Healthcare is taking steps to significantly expand its personalized care management program by leveraging AI to identify risks faster and simplify patient care.
Through this initiative, Cigna’s care teams can use predictive analytics to identify individuals who may benefit from support and intervention early on, helping to avoid further negative outcomes and disease progression in the future.
The insurer also has more than 1,250 clinicians, including nurse managers and behavioral health specialists, to guide the journey of care. They are empowered to coordinate care between health care providers and points members, and to make available supports that may be beneficial to you through your health plan.
Cigna said it expects the number of members with new or complex health needs to increase by 20% with the expansion of the program, which supports disease conditions such as cancer, heart disease, kidney disease, high-risk pregnancy and behavioral health conditions.
Dr. Stanley Crittenden, chief medical officer of Cigna Healthcare, said in an interview with Fierce Healthcare that as healthcare becomes increasingly complex, the need for more personalized care pathways and support becomes even more important.
Being able to more quickly identify patients at risk of developing or worsening complex diseases “would make a much more meaningful difference both clinically and economically,” he said.
“We believe these enhancements will help bring care and support to people at the right time,” he added.
For example, Cigna estimates that these care management programs will reduce healthcare costs by an average of $2,000 each year for engaged patients, resulting in total savings of $200 million over the next three years.
Additionally, care management programs have shown promising results to date, including a 42% reduction in avoidable hospital stays. It also reduced the identification of possible breast cancer, colon cancer, and lung cancer diagnoses by 55, 46, and 37 days, respectively.
Cigna said nearly three-quarters (72%) of patients with depression who connected with a behavioral health professional saw clinically meaningful improvements in their systems.
According to the insurance company, customer satisfaction with the care management program is 95% of those surveyed.
Crittenden said advancing the member experience with these programs also pays off clinically.
“We want to make sure they are experiencing our programs, systems and processes in a positive way,” he said.
While AI is helping to enhance care management programs, making it easier for clinical teams to personalize interactions and surface valuable support, the human touch remains at the heart of this effort, Crittenden said.
He said sometimes just having someone easily reachable by phone, text or digitally can be enough to set a patient on the right path.
“At the end of the day, health care is a business about people taking care of people,” Crittenden said.
