In study, insurer shows cost benefits of smarter health decisions by patients

BLOOMFIELD, Conn. Americans can lower their total medical costs significantly by taking simple steps to prevent or manage disease and by switching to generic drugs whenever possible, new research from health insurance giant Cigna confirmed.

A new, multiyear study compared the healthcare claims of 897,000 Cigna customers enrolled in consumer-driven health plans, preferred provider organizations and health maintenance organizations. Based on its findings, Cigna asserted that beneficiaries covered by its Cigna Choice Fund CDH plans “improve their costs without compromising care by becoming more engaged in improving their health and by becoming informed healthcare consumers,” according to a company report.

“When Americans engage in health-smart habits, such as participating in health coaching and disease management programs, substituting generic medications for brand-name drugs and avoiding unnecessary trips to the emergency room, their total medical costs went down 15%,” the report noted. That resulted in an average savings of $358 per person in the first year, Cigna noted.

Behind the cost reductions, according to the insurer, were higher-than-industry-average rates of participation by Cigna CDH plan members in health coaching and disease management programs, as well as higher generic drug substitution rates. “Cigna CDH plan participants who also have Cigna Pharmacy Management benefits choose generic equivalent drugs 70% of the time,” the company noted.

Avoiding unnecessary emergency room visits also is key to health cost savings, the report noted. “CDH plan enrollees use the emergency room at a 13% lower rate than individuals who have HMO and PPO plans,” the company asserted. “When Cigna Choice Fund customers visited an urgent care facility, their doctor's office or convenience clinic instead of the ER, they saved an average of $800.”

“The evidence is clear,” the report’s authors asserted. “Given the right incentives, the right health improvement programs, useful cost and quality information, and easy-to-understand correspondence, individuals are making rational, wise and successful healthcare decisions.”