Here’s what industry experts think after Cigna’s business model shift.
Cigna’s cultural shift to publish its healthcare findings in medical journals to help drive health improvement, is likely to be mimicked by others in the industry, according to key opinion leaders.
“While large, public health plans have infrequently supported health services research, many smaller, more entrepreneurial companies have been very active in publishing their findings,” says Ron Geraty, MD, CEO AxisPoint Health.
For example, at AxisPoint Health, the scientists, mathematicians and clinicians from its analytics department have published in American Journal of Managed Care, Clinical Pediatrics, Archives of Pediatric and Adolescent Medicine, among others.
““We…believe that we have a responsibility to have our work reviewed and published in order to contribute to better healthcare,” says Geraty. “[Cigna is] joining the ranks of companies who believe they have not only a responsibility to their patients and investors, but to the field of healthcare services, and contribute by researching and publishing findings and results,” Geraty says.
“While there are different corporate cultures, there is basically one approach to ‘insuring’ medical and pharmacy bills-this is insurance, not healthcare. Cigna and other health plans are increasingly getting into healthcare and with these shifts, their priorities will change. Most companies have focused on patient satisfaction rather than health outcomes. As health insurance companies incorporate more providers and more direct care into their approaches, they’ll be expected to shift their focus from ‘experience’ to ‘outcomes’,” Geraty says.
Entities such as Coventry Workers’ Comp Services (Coventry), a work comp managed care organization have conducted similar research with data in the area of drug trends, according to the company’s Vice President, Product Development Anne Levins.
“Every year we publish a number of research papers including a drug trends analysis that incorporates our robust data set of all prescriptions that have been processed for injured workers accessing the program,” Levins says. “The report focuses on educating our employers, payers and others on the trends in the pharmaceutical arena and makes suggestions on how to correct any adverse trends that are occurring. Similarly, we have plans to develop other trend reports in the future given the size and scope of our data warehouse. Whether or not other plans will explore these avenues we would anticipate that yes, when a few leaders get out there with their data and analysis, others will follow.”
Ellen Kelsay, chief strategy officer at National Business Group on Health, says that the Group supports all efforts to leverage learnings to improve how healthcare is accessed and delivered.
“We believe gathering data insights, and turning those insights into actionable best practices, will drive improved outcomes which ultimately benefit consumers and employers. Data transparency is essential to improving and optimizing the healthcare industry,” Kelsay says.