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Triple Integration of Benefits Results in Lower Healthcare Costs for Employers

Analysis  |  By Jay Asser  
   January 23, 2023

A study finds integrating medical, pharmacy, and behavioral benefits reduces total costs, benefiting both employees and employers.

Focusing on health outcomes and affording employees a more personalized healthcare journey can save employers money, according to a study by Cigna.

Aon, the firm that conducted the study, analyzed medical claims of over two million Cigna members who receive coverage through their employers from 2020 to 2021.

The findings showed that Cigna's integrated employer clients saved $148 per member per year in 2021.

Cigna then used a similar study method to determine the financial impact of having employees participate in health improvement programs, such as wellness coaching, and found increased savings of over $1,400 per member per year.

When members with specific high-cost conditions and therapies were enrolled in a triple-integration plan and needed speciality medicines, the savings were nearly $9,000 per member per year. That increased to more than $11,000 when the speciality drug was for an inflammatory conditions like rheumatoid arthritis and nearly $17,500 for members who took speciality drugs and have a confirmed depression diagnosis.

"Integrated benefits provide a real-time, connected platform that enables us to anticipate our customers' unique health needs and support them as they make important health care decisions – driving lower costs over time," said Katy Wong, chief pharmacy officer of Cigna Pharmacy.

"There is tremendous value for employers in having this holistic view across the continuum of care for their workforce. It produces significant savings on health care, which they can pass along to their employees, and it also improves the health of their workforce, which fuels productivity and business growth."

Additionally, the study found that integrating benefits can help lower the costs of chronic conditions. When members were enrolled in a triple-integrated plan, nearly $400 were saved per year for members with a musculoskeletal diagnosis, more than $1,400 saved per year were when an individual with a musculoskeletal diagnosis was engaged with a health coach, and almost $2,500 saved per member per year with a diabetes diagnosis.

Members with integrated benefits and support from health improvement programs also needed fewer emergency room visits and fewer costly invasive in-patient procedures, the study revealed.

Members with diabetes had a 17% lower rate of avoidable emergency room visits, while members with musculoskeletal conditions experienced 133% lower rate of surgeries in an in-patient setting, 26% lower rate of opioid overdoes, and 16% fewer interventional procedures.

Todor Penev, commercial analytics leader at Aon, said: "Employers should feel confident that integrated benefits deliver on the promise of improved health outcomes and ultimately lower the financial risk to the employer, helping build a more resilient workforce."

Jay Asser is an associate editor for HealthLeaders.


KEY TAKEAWAYS

Cigna's study, conducted by firm Aon, examined medical claims of over two million Cigna members who receive coverage through their employer from 2020 to 2021.

Cigna's integrated employer clients saved $148 per member per year in 2021, while those participating in health improvement programs saved over $1,400 per member per year.

The savings were also apparent for members taking speciality medications and those with chronic conditions.

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