Integrated Medical, Pharmacy and Behavioral Benefit Design Delivers Better Health Outcomes, Improves Affordability

February 21, 2021
MHE Staff

Connecting physical and mental health delivers better engagement, outcomes, and lowers costs.

Taking a whole-person approach to health by integrating medical, pharmacy and behavioral benefits drives better health engagement, outcomes and lowers total healthcare costs, according to Cigna's fifth annual Value of Integration study.

This year's recent findings are based on a two-year analysis of more than 2.2 million customer medical claims from Cigna customers who receive coverage through their employer.

"Employers continue to find great value, both for their organization and their workforce, by offering fully integrated benefits that make health care simple, more predictable and ultimately more affordable, while best supporting individuals' physical and mental health," said Matt Totterdale, senior vice president, Cigna Pharmacy. "With over 30 years of designing and building our benefits to work together as one, we're able to see every step of our customers' health journey — anticipating needs, engaging our customers and their providers early and providing individualized, one-on-one ongoing support, which is increasingly important as more patients are relying on virtual care during COVID-19."

Integrated benefits reduces costs

In particular, the study shows that employers with Cigna's integrated medical, pharmacy and comprehensive behavioral benefits continue to see meaningful savings in total medical costs, as compared to those with standalone medical and pharmacy coverage. According to the study, on average, Cigna clients recognized savings of $227 annually per customer1. For individuals identified as having a health improvement opportunity, average cost savings increase to $4,741 annually per customer.

Savings can be even more significant when looking at customers living with high-cost conditions. The study shows total medical cost savings of more than $6,700 for individuals with an oncology diagnosis and more than $2,700 for individuals with a diabetes diagnosis.

"Through effective contracting with pharmaceutical manufacturers, collaborating with providers, proactively engaging customers and acting on real-time data and insights, we're able to get ahead of gaps in care and drive meaningful interventions," said Totterdale. "We are by their side, helping them take steps to achieve their best health — body and mind. This total health care approach eliminates those gaps, helping to protect against surprise costs and driving better outcomes for our customers."

Integrated benefits increases engagement

According to the study, Cigna's integrated customers are significantly more engaged in their health and experience greater opportunity for improved health outcomes. In fact, the study found:

  • Higher engagement for customers living with depression (21%), diabetes (11%) or an oncology diagnosis (10%).
  • A 25% higher customer engagement in Cigna programs such as counseling, lifestyle or wellness coaching, smoking cessation, and case management for more complex conditions.

The study also reveals that engaged customers are:

  • Less likely to have emergency room visits, especially those living with depression (16%), diabetes (14%) or musculoskeletal conditions like arthritis or back pain (11%).
  • More likely to use in-network, high-performing providers (7%).

Through integrated benefits, Cigna is able to identify and engage early with preventive health screens and predictive modeling. This holistic approach to customer health looks across all benefits, engaging providers and working to remove barriers to care. Cigna health coaches are able to support customers every step of the way, delivering ongoing support by continually screening for gaps in care, mental health co-morbidities, and opportunities for cost savings like financial assistance and programs that cap the cost of certain drugs, including insulin.

"This holistic view gives us access to the entire health profile, including behaviors, preferences, conditions and medications. We can then accurately leverage predictive analytics to get ahead of diagnoses and trigger outreach to customers and providers to guide them to the next best action," said Young Fried, chief clinical officer, Cigna Pharmacy.