Study: Connected Pharmacy, Medical Benefits Improves Patient Proactivity in Healthcare

Integrated pharmacy and medical benefits may increase patient engagement in health coaching.

A new study indicates that Americans whose pharmacy and medical benefits were both administered by Cigna are more likely to play an active role in their healthcare compared with patients whose benefits were administered by different companies, according to a company press release.

Included in the study were 4.8 million Cigna customer claims from 2016. Approximately half of patients had both pharmacy and medical benefits administered by the insurer, while the other half had pharmacy benefits administered by another pharmacy benefit manager (PBM). The investigators matched patient cohorts based on demographics, diseases, access to health improvement services, plans, and geographic location.

Overall, patients with both benefits administered by Cigna were observed to be more active in health coaching and case management programs, according to the release.

The increased engagement among this population was discovered the save $253 for each employee who was a candidate for a health improvement program compared with patients whose pharmacy benefits were administered by another PBM, according to the study.

These results suggest that employers should consider administering both pharmacy and medical benefits for their employees through the same company, according to Cigna.

When both benefits were managed by Cigna, 12% more patients participated in health coaching and case management, with an additional 12% more individuals completing health improvement activities, according to the release.

Cigna said that integrated health benefits provides an improved view of a patient’s overall health and what is driving spending.

“Every time a prescription is filled, there is an underlying medical issue. A real-time view of our customers’ health needs across both their pharmacy and medical benefits enables us to more easily identify and support those who need help in managing their health,” said Scott Josephs, MD, national medical officer, Cigna. “We’re able to provide personalized guidance to customers on actions that will drive better health — such as improving adherence to their medications – and provide cost savings for them and their employers.”

Cigna found that better health engagement resulted in significant savings for specific diseases, including diabetes. When both benefits were administered by Cigna, employers saved an average of $2816 annually for each patient with diabetes, according to the study.

Notably, employers also saved $74 per member per year on medical costs when both benefits were administered by Cigna.

“Even the best doctors and most effective medicines can only do so much if patients are not also actively involved in improving their health. Under the plans we administer, pharmacy is the most frequently used benefit, and we use those touchpoints to encourage customers to participate in programs available across their benefits,” said Jon Maesner, PharmD, Cigna chief pharmacy officer. “The study helps confirm the added value we can provide to customers and clients when we are able to use this connected approach.”