Cigna expands AI capabilities to intervene earlier in chronic care

Cigna Healthcare is expanding its personalized care management programs, using AI and predictive analytics capabilities to identify members who would benefit from earlier intervention. Cigna said the expansion will reach 20% more members with emerging or chronic health needs, focusing on cancer, heart disease, high-risk pregnancy, behavioral health conditions and kidney disease.

"[Healthcare] can be difficult to navigate, especially when someone is facing a new diagnosis or complex condition. Our goal is to make it easier for customers to connect with an experienced Cigna Healthcare clinician who can help them understand their options and make the most of the support available through their health plan," Stanley Crittenden, M.D., chief medical officer at Cigna Healthcare, said in a press release.

"With earlier guidance, we can help customers get the right care at the right time and avoid more serious and costly health complications."

Cigna Healthcare said its new capabilities will help members manage their conditions more effectively, reducing medical costs by an average of $2,000 per year, totaling $200 million in savings over the next three years.

The company's existing care management programs have yielded promising results, with a 95% satisfaction rate and a 42% reduction in avoidable inpatient stays among members who engage with care management support early, the announcement noted.

With the help of AI, Cigna Healthcare said its personalized care management programs will be enhanced to offer more individualized engagement. Customers will be able to connect with clinicians through their preferred mode of communication, including text, phone or email.

Additionally, predictive models and AI-powered insights will help the payer identify emerging health needs sooner, enabling patients and clinicians to intervene before a condition becomes chronic, the company said.

"As costs for hospital care, emergency services, and prescription drugs continue to rise, we are investing in tools and clinical programs that help customers avoid unnecessary hospitalizations, better manage chronic conditions, and reduce the likelihood of more serious and expensive health events later," Bryan Holgerson, president at Cigna Healthcare U.S. and executive vice president of customer health outcomes at The Cigna Group, said in the press release.

"By combining predictive analytics, AI-enabled capabilities, and clinical expertise, we can identify health needs earlier and connect more customers with personalized support when it has the greatest impact."

The program expansion was designed to complement Cigna's existing personalized care services, including My Personal Champion, a program that offers members facing complex health conditions specialized assistance and a dedicated point of contact to coordinate support.

Jill Hughes has covered health tech news since 2021. Her coverage areas include cybersecurity, HIPAA compliance, interoperability, AI and EHRs.