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Want to avoid risky surgery?

Predictive data helps us identify members who are at risk for knee, shoulder, back, or hip surgery up to one year in advance. This is one way we help our members avoid risky surgery and access the personalized care that’s best for them.

Person holding a child on their shoulders

Prediction prevents chronic and costly conditions

 

"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. Douglas Nemecek, Chief Medical Officer of Behavioral Health at Evernorth® Health Services

 

Pharmacist handing prescription to prescriber

Integration makes health care better

Our research shows that members with integrated medical, pharmacy, and behavioral benefits experience:

  • 133% lower rate of surgeries in an inpatient setting1
  • 16% fewer nonsurgical procedures, such as injections and biopsies, which were avoided because they were unnecessary1

“When people are connected to the right resources as early as possible, they can stay engaged in the right care,” Dr. Nemecek said. “That’s how we optimize health outcomes.”

A better standard of care

Cigna Pathwell Bone & Joint®, a condition-specific care program, is our evidence-based, coordinated, and personalized approach to bone and joint care.

  • Members at risk for spine, knee, hip, or shoulder surgery are identified before pain can slow them down and make them sit on the sidelines.
  • Each member has easy access to their own dedicated care team member, who will champion and coach them to success.
  • Patients get care the way they want it—through personalized activities, assessments, expert content, treatment guidance support, care navigation tools, and email reminders.
Medical professional talking to patient

1.  “Value of Integration Study.” Aon's 2022 Value of Integration study is based on a two-year analysis (2020–2021) of medical claims of over two million Cigna Healthcare members who receive coverage through their employers. Aon was independently engaged to design and perform the study. The book-of-business study leveraged Aon’s proprietary Cost Efficiency Measurement, a match case-control methodology, comparing groups of individuals who are alike (age, gender, health status, and benefits) but differ in terms of their coverage of medical, pharmacy, and behavioral benefits. Cigna Healthcare used a match case-control methodology developed at Harvard University to produce supplementary statistics on different subsets of members (those with certain comorbidities, those who engaged in health improvement activities, etc.).