Health Care Strategy: Shifting Behaviors, Not Costs

Customers shown to “own” their health and health spending, resulting in better health, a better experience and a better bottom line for themselves and their families

April 24, 2014- BLOOMFIELD, Conn.–(BUSINESS WIRE)–Consumer driven health plans are helping literally millions of American workers and their employers reduce their health care expenses, by shifting behaviors, rather than shifting costs, according to a study of health claims by global health service company, Cigna (NYSE:CI).

Released this week, the Eighth Annual Cigna Choice Fund Experience Study compares the actual claims experience of more than 3.6 million Cigna customers who are enrolled in a CDHP, a traditional PPO or HMO health plan.

The annual study provides empirical evidence that individuals covered by Cigna CDHPs are more likely to “own” their health and health spending: use health improvement programs, comply with evidence-based medicine best practices, and lower their health risks, resulting in improved total medical expenses by 12 percent.

One employer that is seeing the benefits of conversion to a Cigna CDHP is the City of Lakewood, CO. According to the City of Lakewood Manager of Benefits Nancy Rhode: “Over the last three years, we’ve seen our employees’ total plan spend increase by only two percent. During that same period we saw generic usage increase from 73 to 81 percent. In addition, plan participants are using services more efficiently, saving themselves and the City money.”

“This is happening because our employees are making more informed and healthier decisions,” Ms. Rhode explains. “They are increasingly choosing more wellness visits, more convenience care, fewer unnecessary ER visits, and choosing generic medications over expensive brand names.”

A similar experience is also documented among millions of American workers and thousands of employers in the Eighth Annual Cigna Choice Fund Experience Study. According to the study, when compared to customers in traditional PPO and HMO plans, those in a CDHP:

Are more likely to “own” their health:

Are more engaged: Cigna CDHP customers were nearly 50 percent more likely to complete a health risk assessment, and those with a chronic illness were up to 41 percent more likely to participate in a disease management program than those enrolled in a traditional plan.
Were more likely to actively manage their health benefits: Seventy-five percent of Cigna CDHP customers have registered for their personal health portal or mobile app and are 82 percent more likely to log in to manage their health benefits and access cost, care quality and procedure information to help them choose the most highly-rated and most cost-efficient care providers.
Improved their health:

Over the last three years, we’ve seen our employees’ total plan spend increase by only two percent. During that same period we saw generic usage increase from 73 to 81 percent

Received higher levels of recommended care: First-year Cigna CDHP customers had the same or higher compliance with roughly 500 evidence-based medical best practices 96 percent of the time compared to their counterparts in traditional plans. Compliance continued to increase in the second year.
Demonstrated lower health risks: According to the study, employers that fully transitioned to offering only a CDHP option had 14 percent more low-risk individuals and 28 percent fewer high-risk individuals compared to customers in a traditional plan.
Improved their health expenses:

Reduced total medical costs: Cigna CDHP medical cost trend was 12 percent lower than traditional plans during the first year. Cumulative savings over 5 years of $7,900 per employee can be achieved. Cost reductions were achieved without employers shifting out-of-pocket health expenses to their employees. On average Cigna Health Reimbursement Arrangement (HRA) customers paid 21 cents out of every dollar out of their own pockets, while traditional customers were paying 24 cents.
Were more savvy consumers of health care: Customers with Cigna Choice Fund plans and Cigna pharmacy benefits were more likely to choose generic medications compared to those in a traditional plan. In addition, CDHP customers used the emergency room at a five percent lower rate than individuals enrolled in HMO and PPO plans.
“Constraining health care costs doesn’t have to mean shifting costs from one area to another,” said Cigna President, Regional and Operations, Matt Manders. “Over the past eight years, we at Cigna have seen that by improving health care quality and transparency, and by incentivizing healthy behaviors, we reduce the total cost by shifting behaviors, rather than shifting costs.”

With a compounded average growth rate of 24 percent since 2008, as of December 31, 2013, Cigna provides CDHP coverage for 2.6 million Americans.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America, Cigna Life Insurance Company of New York and their affiliates. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, and other related products including group disability, life, and accident coverage. Cigna has sales capability in 30 countries and jurisdictions, with approximately 80 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit