New Study Measures Impact of CIGNA's Consumer-Driven Health Plan on Costs,
Quality and Consumer Decision-Making
BLOOMFIELD, Conn., Nov. 8, 2006 /PRNewswire-FirstCall/ -- The results
emerging from a year-long analysis of first-time users of CIGNA
HealthCare's consumer-driven health care plans indicate that these members
are becoming more cost-conscious, but are not sacrificing recommended care
to save money and are also benefiting financially. Key findings from the
analysis show that:
-- CIGNA Choice Fund is helping to control costs -- Costs for CIGNA Choice
Fund HRA and HSA members decreased and were about 16 percent lower than
costs for those enrolled in traditional plans;
-- Cost-shifting did not occur -- Member out-of-pocket costs decreased for
CIGNA Choice Fund HRA members when compared to the prior year;
-- Members continued to receive appropriate care -- CIGNA Choice Fund HRA
and HSA members increased their use of preventive care services, health
care quality was maintained on hundreds of measures of evidence-based
medicine, and use of medications that support chronic conditions
increased, signaling that members are not foregoing needed care;
-- Consumers are becoming more engaged -- Consumers report increased
awareness and engagement in managing their health care as compared to
two years ago.
"Our experience illustrates clearly that when structured and
implemented effectively, consumer-driven health plans offer a viable
approach to addressing the critical challenges facing our health care
system - improving quality and managing costs," said H. Edward Hanway,
chairman and chief executive officer of CIGNA Corporation. Hanway
referenced some of the key findings of the CIGNA study during a keynote
address today at the Second Annual Consumer-Centric Healthcare Congress in
Washington, D.C. He also urged health benefits providers to become "health
advocates for consumers" and called for an industry-wide commitment to
providing quality and cost information that builds consumer knowledge and
fosters consumer engagement in health care.
Earlier this year, CIGNA HealthCare released the first phase of
findings based on six months of data in one of the largest consumer-driven
health care studies to date. The latest findings based on 12 months of data
show accelerated medical cost savings with CIGNA Choice Fund -- a
difference of about 16 percent -- when compared to the traditional plan
population studied, validating the initial analysis.
Members reduced their share of health care expenses
The data show that cost-shifting did not occur. Total out-of-pocket
expenses for CIGNA Choice Fund Health Reimbursement Arrangement (HRA) plan
members fell from 19 percent of total health care costs to 16 percent,
excluding the costs of premiums, after their switch to a consumer-driven
plan. Premium contributions are typically 10 percent to 20 percent lower
for consumer-driven plans, meaning the overall cost saving to members is
likely somewhat higher than the study result indicated. Many members also
benefited from the employer-financed reimbursement account. The average
total cost share of 16 percent would have been 27 percent without the
availability of the reimbursement account.
Member out-of-pocket costs for those enrolled in the HRA plan are
similar to those of members enrolled in a traditional plan. Cost savings
were seen across varied levels of health care consumption as well, with
approximately 92 percent of CIGNA Choice Fund HRA members experiencing
lower out-of-pocket costs than if they had remained in a traditional plan.
At the lowest spending level (claims less than $1,000), member share of
costs declined from 39 percent to 16 percent. At the moderate spending
level (claims of $1,001-$7,999), member share of costs declined from 28
percent to 26 percent. And at the highest spending level (claims of $8,000
and higher), member share of costs remained stable at 11 percent.
"These findings counter the perception that consumer-driven plans
simply move more costs to consumers or can only benefit the healthy. The
results show that a thoughtful plan design can remove costs from the
system, not just shift them elsewhere," said Michael Showalter, senior vice
president of health care strategy and marketing for CIGNA HealthCare. "And
more importantly, the right plan design also helps promote quality
improvement."
Members continue to receive recommended care
In an evaluation of compliance with 302 evidence-based measures of
health care quality, for example, women having a mammogram in the past 24
months or diabetes patients having a physician visit in the last six
months, CIGNA Choice Fund members continued to receive recommended care at
the same or higher levels as those enrolled in traditional plans for
approximately 96 percent of the measures studied. In addition, preventive
care visits for CIGNA Choice Fund members increased by eight percent over
the prior period, with these members receiving preventive care at higher
rates than those enrolled in traditional plans by 12 percent.
Consistent with study findings published earlier this year, CIGNA
Choice Fund members are also more compliant with medications that manage
ongoing conditions, and more likely to engage in preventive care when
compared to traditional plan members.
Changing consumer attitudes highlight ongoing need for information and
support
In addition to examining claims data to study behavioral changes after
enrollment in a consumer-driven plan, CIGNA HealthCare also conducted a
member survey to examine consumer engagement in health care and attitudes
and behaviors related to use of health care information and health care
costs.
The survey showed that members polled are more engaged in their health
care than they were two years ago, regardless of the type of plan in which
they were enrolled. For example,
-- More than two-thirds (68 percent) of respondents reported they are more
actively working to maintain or improve their health than they were two
years ago.
-- Fifty-eight percent said they are more personally involved in making
decisions about their health than they were two years ago.
-- More than half of respondents agreed they are more able to make
informed decisions about their health care (54 percent) or ask the
right questions when they talked to their doctor (60 percent) than they
were two years ago.
CIGNA Choice Fund members were more likely than those enrolled in
traditional plans (37 percent v. 28 percent) to agree that they used their
health plan's programs, such as a discount program or health coaching, to
help them improve or maintain health.
While many consumers reported that their awareness of the costs and
quality of care had increased compared to two years ago, only about four in
ten surveyed agreed that they are usually aware of the actual costs of the
health care services they get or have an easy way to find out how much
health care services would cost. About six in ten (59 percent) respondents
agreed they have an easy way to find information on health care quality.
Consumers of both plan types expressed a clear preference for quality
information, rather than cost information, to help them choose doctors or
facilities for care. This was true for all types of service, including
selecting a facility for inpatient, outpatient or high-tech radiology
services, selecting a physician for an office visit or a lab for lab tests.
For example, about three-fourths (76 percent) of members indicated they
would use quality comparison information to select a hospital for an
inpatient procedure, such as heart surgery. By contrast, only half
indicated they would use cost comparison information to do so.
"This finding reaffirms that quality comparisons are more meaningful to
consumers as they make decisions on where to seek care," Showalter said.
"It also tells us that our continued strategy of providing consumers first
with information on the quality of care and then information on the cost of
that care, will be the approach most valued by consumers."
"Consumer-focused approaches in health care have awakened the need for
more information and support that helps consumers make informed decisions
and helps them to better interact with the health care system," said
Showalter. "Though we are encouraged by the progress that's been made, we
also recognize we must continue our work to address the issues that
consumers tell us would improve their experience."
About the Study
This study examined claims and clinical data of approximately 38,200
continuously enrolled members who switched from a traditional HMO or PPO
plan to one of CIGNA HealthCare's HRA or HSA plans in 2005. The analysis
compared this group's claims for the 12-month period January 2005 through
December 2005 to their claims from the same period in 2004. To examine
pharmacy costs and utilization, the study reviewed the claims experience of
2,300 CIGNA Choice Fund members who had a combined medical and pharmacy
deductible through CIGNA HealthCare. In addition, the study also compared
this group's health care costs and utilization patterns to those of 231,600
members enrolled in a traditional HMO or PPO plan from the same employer
groups during the same January-December 2005 time period. Pharmacy analysis
for the traditional population was based upon 109,000 members.
The study drew upon data from 44 different employer groups offering
CIGNA HealthCare's consumer-driven health care plans to employees. The
consumer survey was based on a telephone survey of 807 CIGNA HealthCare
members, 406 enrolled in CIGNA Choice Fund plans and 401 enrolled in
traditional plans from among these same employer groups, fielded from
August 8 to September 6, 2006. This survey has a margin of error of +/- 4.9
percent.
About CIGNA HealthCare
CIGNA HealthCare, headquartered in Bloomfield, CT, provides medical
benefits plans, dental coverage, behavioral health coverage, pharmacy
benefits and products and services that integrate and analyze information
to support consumerism and health advocacy. "CIGNA HealthCare" refers to
various operating subsidiaries of CIGNA Corporation (NYSE: CI). Products
and services are provided by these operating subsidiaries and not by CIGNA
Corporation.
SOURCE CIGNA HealthCare
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Related links:
http://www.cigna.com
CONTACT:
Amy Turkington of CIGNA, +1-860-226-3489 or
amy.turkington@cigna.com
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