April 2017

Aligning with Doctors to Improve Health and Savings

Doctors are the top influencer of consumer health choices1 which means they are a major driver of cost. One of the many benefits of using Cigna for your organization’s pharmacy benefits is that we are closely aligned with contracted doctors in our network including our collaborative care models. We leverage these relationships and influence the value-based contracting and incentives.  And we continuously improve the relationship by sharing actionable and relevant patient-specific information.

How do we do it?

We contract with doctors with the comprehensive health of patients in mind, meaning fee schedules and other payments aren’t just office visit based – they are outcome and incentive based. We also can connect them to health and pharmacy engagement programs sponsored by our clients and support them by providing extensive patient reporting. For example:

  • Narcotic therapy management program patient-specific alerts can be sent to multiple prescribers showing prescribing patters for one common patient who may be at risk for opioid use disorder.
  • Gaps in care reports are patient-specific and contain integrated medical and pharmacy information.
  • Rx saving reports are patient-specific and actionable.

Why does it matter? 

Standalone pharmacy benefit managers may send drug-specific information to doctors but there is no contract, no relationship and no ability to share patients’ medical/pharmacy information. By working closely with our doctors – bringing pharmacy and medical together to give them 360O insights into their patients’ health – Cigna sees 8.5% additional medical and pharmacy gaps in care closure rate. And clients using Cigna's fully connected medial and pharmacy plans see a $77 per customer per year additional average annual medical savings. 

  1. The Consumer Health Mindset, The Futures Company, NBGH, AonHewitt, 2014
  2. 2015 Cigna National Book of Business, control group study of integrated versus carve-out clients.
  3. 2015 Cigna National Study of Value of Integration – analysis of integrated clients vs. those with Cigna medical and outside PBM, full year 2014 book of business – average medical savings. Individual client/customer results will vary and are not guaranteed.