CIGNA Choice Fund(SM) Study Provides New Insights on Consumer Decision-making in Consumer-Driven Health Plans

BLOOMFIELD, Conn., Feb. 2, 2006 /PRNewswire-FirstCall/ -- A CIGNA HealthCare analysis of 42,200 first-time users of consumer-driven health plans found these consumers generated an eight percent reduction in medical costs and made positive changes in health behavior, such as increasing their use of medications to treat chronic health care conditions.

"These study results show that given greater choice and control, the right incentives and actionable decision support, CIGNA Choice Fund members are becoming more involved in their health care and health care decision-making, while not compromising needed care," said Michael Showalter, vice president of consumerism for CIGNA HealthCare.

CIGNA's national study is one of the largest and most comprehensive analyses of consumer-driven health plans conducted to date. The medical claims study included two separate analyses: the first comparing the claims experience of 42,200 continuously enrolled members before and after their switch in 2005 from a traditional HMO or PPO plan to one of CIGNA HealthCare's HRA or HSA plans, and the other comparing this group's health care costs and utilization patterns to a control group of 140,200 members enrolled in a traditional HMO or PPO plan from the same employer groups' populations.

Managing Medical Costs

Total medical costs excluding prescription drug expenses for those enrolled in a CIGNA Choice Fund plan declined by approximately eight percent compared to the prior period, while costs for those enrolled in a traditional HMO or PPO plan increased by approximately four percent.

Changes in health care spending were driven by a reduction in both inpatient and outpatient facility costs, which declined approximately five percent and 12 percent respectively, when compared to the prior period. Inpatient and outpatient facility costs for CIGNA Choice Fund enrollees were also lower when compared to costs for the control group who were enrolled in a traditional plan. Importantly, while overall costs decreased for these services, the actual number of admissions increased compared to the prior period, showing that consumers received needed care in cost-effective ways.

The study released today is also one of the first to provide early data comparing cost among groups of consumers who had similar levels of claims in the prior period --- classified in the study as low, medium or heavy users of health care services -- to examine changes in decision-making after enrollment in a consumer-driven health plan.

The analysis showed that cost savings were observed across all categories, with the most pronounced savings occurring among medium and heavy users of care - those with medical (non-pharmacy) claims of $1,000-$8,000 and in excess of $8,000.

"This early data suggests that the change in health care decision-making encouraged by a consumer-driven plan doesn't end once a consumer satisfies the deductible or reaches the out-of-pocket maximum," Showalter said. "It also signals that health advocacy programs like health coaching, along with access to information tools and consumer advisors, are essential components of a consumer-driven health plan," Showalter said, noting that the goal of these programs is to help members improve their health, which, in turn, controls costs.

Improving Medication Compliance

The study indicated that when compared to the prior period, CIGNA Choice Fund members who had prescription drug coverage through CIGNA HealthCare significantly increased their usage of medications used to control diabetes (+18%), asthma (+8%), high cholesterol (+23%) and to prevent heart attacks (+18%). They were more discerning in their use of some types of prescription medications for which alternatives are available over-the-counter, such as medications for migraines (-4%) and anti-ulcer drugs (-7%).

Notably, the total days supply of prescription drugs obtained by CIGNA Choice Fund members increased compared to the prior period, but the cost per day for the medications decreased, suggesting that CIGNA Choice Fund members did not skip medications but instead made more cost-effective decisions.

"CIGNA Choice Fund members appear to be taking advantage of the many decision support resources available, such as CIGNA's pharmacy-specific online price quote tool, to make more cost-effective decisions," Showalter said. "But in this process, they are improving their compliance with medication therapy, which helps lead to better health and reduced costs for other types of services."

Costs for prescription drugs for CIGNA Choice Fund members, while increasing compared to the prior period, were five percent less than the costs for the control group of members enrolled in a traditional plan.

About the Study

The study included two separate analyses. First, it examined the claims experience of 42,200 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 six-month period January 2005 to June 2005 to their claims from the same period in 2004. To examine pharmacy costs and utilization, the study reviewed the claims experience of 29,577 CIGNA Choice Fund members who also had pharmacy coverage through CIGNA HealthCare.

In addition, the study also compared this group's health care costs and utilization patterns to those of 140,200 members enrolled in a traditional HMO or PPO plan from the same employer groups' populations during the same January-June 2005 time period. To examine pharmacy costs and utilization, the study reviewed the claims experience of 130,550 members enrolled in traditional plans who also had pharmacy coverage through CIGNA HealthCare.

The study drew upon data from 44 different employer groups offering CIGNA HealthCare's consumer-driven health care plans to employees. Total medical cost as used in the study represents overall medical (non-pharmacy) costs for both consumers and employers. Costs for catastrophic claims totaling more than $50,000 in either period for all populations were excluded from the analysis to reduce random variation and improve the reliability of the results.

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 . Products and services are provided by these operating subsidiaries and not by CIGNA Corporation.

First Call Analyst: Ted DetrickFCMN Contact: karen.godlewski@cigna.com