For those with back, shoulder, hip, or knee pain, getting the right care at the right time can mean the difference between sitting on the sidelines and stepping up to coach that peewee soccer team. Or going for a walk, or attending that concert, or heading into the office.
Because whatever brings the joy to life is easily sidelined by MSK pain.
The threat of missing out is the reality of more than half of adults in the United States. One out of every two people over age 18 have a musculoskeletal (MSK) condition of the spine, shoulder, hip, or knee.1 That includes our families, coworkers, and one out of every two of us.
Getting the right diagnosis and treatment for an MSK condition can be complicated. For many, the quest to understand their MSK condition and search for care sends them down a confusing path at a time when they are in pain and least able to navigate it. Instead of clear direction, patients often face a series of common obstacles -- uncoordinated care, unnecessary tests, potentially avoidable MSK surgeries, and more. These barriers can lead to poor health outcomes and increased costs2 for everyone – patients, families, employees, and employers – as well as frustrated patients, who don’t actually feel any better.
There’s a better way.
The solution to MSK pain: The right care at the right time
Cigna Healthcare believes there is a better way to identify and treat these painful conditions: Help people access high quality, personalized care. That means connecting the dots early and guiding members to the right care at the right time for them, often before MSK problems become worse. This tailored approach is better by design, helping people stay in better control of their health, wallets, and lives.
Here’s how we do it: Personalized, MSK care
We care and want to help MSK patients get better and feel better with quality, affordable MSK care. We have the people and tools to help, so we put them to work:
- First, we use our data to identify members who are at risk for spine, shoulder, hip, or knee surgery (up to a year in advance3). Then, we contact them to make sure they’re okay and getting the care they need. We encourage them to enroll in the Cigna Pathwell Bone & Joint® program, so they can access a wide variety of support before MSK pain can disrupt their lives and lead to more severe consequences, like surgery.
- For those who prefer it, they can access customized content and personalized digital activities to gain greater control of MSK pain.
- Each member is supported one-on-one by a dedicated clinical care advocate through digital messaging or by phone. Advocates customize the program based on insights, assessment responses, and each person’s unique needs, while guiding, motivating, and encouraging their success.
- We take the confusion out of picking a doctor:
- When additional care is needed, the care advocate can help connect members with the right type of provider, with in-person and virtual options, and help them get the most out of their benefits. Care like physical therapy, pain management, or lifestyle support. We can also help members decide if surgery is right for them.
- When bone and joint surgery is needed, we help members find a surgeon and plan everything from surgery to recovery. Members can choose from designated board- and fellowship-certified surgeons who meet our care and quality standards that include:
- Advanced training in specific bone and joint conditions
- A specified number of surgeries or more per year, ensuring their skills are up to date
- Above-average surgery results with fewer complications, compared to national standards
- Part of our $0 surgery benefit. This means zero or low-cost surgery. 100% of care is covered from admission to discharge for covered procedures (after deductible is met for members who have an HSA).4 And if members live more than 60 miles from a Pathwell Bone & Joint surgeon, we’ll even cover some travels costs for surgery.5
Learn More
The Cigna Pathwell Bone & Joint condition-specific care program is designed to help MSK patients get and feel better by improving care quality, eliminating waste, and reducing costs for the benefit of everyone, especially patients. To learn more about how we can help prevent your employees and your business from being sidelined by pain – and unnecessary health care costs – visit cigna.com/better or contact your broker or representative today.
- United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS), Third Edition, 2014. Rosemont, IL. Available at http://www.boneandjointburden.org. Accessed on 12/09/2024.
- Evernorth, “Americans in Motion: The Total Cost of Managing Musculoskeletal Conditions”, Aug. 2022.
- 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.
- 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