Avoid the surgeon’s table – gain control over bone and joint health

Person sitting on chair

Do you – or does know someone you know – suffer from back, knee, or hip pain?

Then you know it can range from dull to debilitating. People with chronic musculoskeletal (MSK) conditions may live in fear of injury, pain, missing work, or missing out on time with friends and family. And many see surgery at the end of the road.

Treating back pain without breaking the bank

MSK conditions cost the health system $420 billion annually, Evernorth research found1. Many of the costs stem from ineffective forms of care such as:

  • Preventable surgeries
  • Poorly timed advanced imaging, including MRIs and CT scans
  • Overuse of opioid and other controlled substances
  • Lack of coordination between providers 

But these costs may be avoidable. Patients whose plans give them the right guidance can find the treatment appropriate for them. That’s where the right solution comes in.

If surgery is on the horizon …

People with MSK conditions often turn to surgery to ease their pain. But surgery may prove ineffective. And in many cases, they can avoid the need. That’s what makes surgery a top avoidable cost. Here’s how the plan can help: 

  1. Coordinate care between providers and services. MSK conditions can’t be treated in isolation.
  2. Prioritize emotional well-being. When emotional pain accompanies physical pain, treatment complexity and costs increase.
  3. Focus on prevention. It’s key to avoiding the long-term pain and costs of chronic MSK conditions.

“It’s absolutely important to address MSK issues as soon as possible and not let them become more severe,” said Dr. Douglas Nemecek, Evernorth Chief Medical Officer of Behavioral Health.

Predicting bone and joint problems before they start

Cigna Pathwell Bone & Joint, a condition-specific program, can identify surgery risk with 75% to 93% accuracy2. It draws on huge troves of data to predict when someone might need surgery, as early as a year in advance.

Through the program, patients get information and guidance. This may include calls to make sure they’re doing well and getting the care they need.

The plan provides a more personalized path through MSK treatment, one that doesn’t need to end in surgery. That’s what makes it better by design.

“Our predictive models can tell us who we should reach out to and engage with sooner, before problems get severe and become a crisis,” Dr. Nemecek said.

Achieving shared goals

Pathwell Bone & Joint helps each patient find and follow their unique care needs. Here’s what participants can expect:

  • A care advocate who offers clinical guidance and works one-on-one with the patient to guide them through their wellness, treatment, and recovery. These live clinical associates share their expertise as they listen, guide, and help.
  • A guided digital experience based on insights and evidence-based guidelines. Patients get care the way they want it – through personalized activities, assessments, expert content, treatment guidance support, care navigation tools, and email reminders.
  • Guidance to the right care at the right time to improve outcomes and reduce costs – goals shared by patients and their employers.

Even when the goal is to avoid surgery, there will still be times when it’s necessary. If that happens, patients have access to surgeons who meet rigorous Cigna Healthcare criteria for quality, volume, outcomes, and affordability.

Surgery comes at no cost, or at low cost, to them. They also get pre- and post-surgery support, and a travel benefit (for surgery with designated provider >60 miles from home)3.

Here to support patients as people

People dealing with MSK conditions are suffering – and they deserve better experiences. Cigna Healthcare provides more guidance, more personalized programs, and stronger connections. That customized health care experience translates into better outcomes and lower costs.

To learn how you can improve health and lower costs through health coverage backed by the Cigna Healthcare suite of preventive, holistic solutions, visit cigna.com/better  or contact your broker or representative today.

  1. Evernorth, “Americans in Motion: The Total Cost of Managing Musculoskeletal Conditions”, Aug. 2022. 
  2. Based on proprietary Cigna Healthcare algorithms, data, and claims analysis to assess potential health risks. Timing and results may vary. Accuracy is an overall model performance measure where the model ranks people in the right order 80% of the time.
  3. Cost share can be as low as $0/100% to the customer, program participation requirements must be met, deductible then cost share applies for HSA plans. Applies when using Pathwell Bone & Joint designated surgeons. Other high-performing in-network provider options available with standard in-network benefit coverage. High-performing providers are providers and facilities that meet our quality and cost efficiency standards. For surgery with designated provider >60 miles from home. Amount varies based on factors such as treatment plan, location and duration of facility stay and are subject to program participation requirements

© 2025 Cigna Healthcare. All rights reserved.

Disclaimer:

Product availability may vary by location and plan type and is subject to change.  All group insurance policies may contain exclusions, limitations, reduction in benefits, and terms under which the policy may be continued in force or discontinued.  For costs and details of coverage, contact your Cigna Healthcare representative. 

Cigna Healthcare medical products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT), Connecticut General Life Insurance Company, Evernorth Behavioral Health, Inc., Evernorth Care Solutions, Inc., Express Scripts, Inc., or their affiliates, and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc., and Cigna HealthCare of Texas, Inc. In Utah, medical products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).

Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT.) (CHLIC), Cigna HealthCare of Connecticut, Inc., and Cigna Dental Health, Inc. and its subsidiaries, including Cigna Dental Health Plan of Arizona, Inc., Cigna Dental Health of California, Inc., Cigna Dental Health of Colorado, Inc., Cigna Dental Health of Delaware, Inc., Cigna Dental Health of Florida, Inc., a Prepaid Limited Health Services Organization licensed under Chapter 636, Florida Statutes, Cigna Dental Health of Kansas, Inc. (KS & NE), Cigna Dental Health of Kentucky, Inc. (KY & IL), Cigna Dental Health of Maryland, Inc., Cigna Dental Health of Missouri, Inc., Cigna Dental Health of New Jersey, Inc., Cigna Dental Health of North Carolina, Inc., Cigna Dental Health of Ohio, Inc., Cigna Dental Health of Pennsylvania, Inc., Cigna Dental Health of Texas, Inc., and Cigna Dental Health of Virginia, Inc.  In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT).  CHLIC policy forms: OK –HP-POL899 et al., POL115; OR - HP-POL862 et al., HP-POL121 04-10; TN – HP-POL767/HCDFB-CVR28 et al., HP-POL134/HC-CER17V1 et al.

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Accidental Injury, Critical Illness, and Hospital Care insurance policies are distributed exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT). THESE POLICIES PAY LIMITED BENEFITS ONLY. THEY ARE NOT COMPREHENSIVE HEALTH INSURANCE COVERAGE AND DO NOT COVER ALL MEDICAL EXPENSES. THIS COVERAGE DOES NOT SATISFY THE “MINIMIUM ESSENTIAL COVERAGE” OR INDIVIDUAL MANDATE REQUIREMENTS OF THE AFFORDABLE CARE ACT (ACA). THIS COVERAGE IS NOT MEDICAID OR MEDICARE SUPPLEMENT INSURANCE.