CIGNA HealthCare is again expanding
the cost and quality information, online tools
and benefit incentives available to members to
help them plan for and make more informed health
care decisions.
Members across the country can now
compare facility costs for certain ambulatory surgical
procedures and high-tech radiology tests like CT
scans and MRIs. We are also introducing a tool
that gives consumers the ability to compare physician
specialists based on their performance on select
quality and cost efficiency measures using a star-based
scoring system. In addition, we will more than
triple the number of markets where the CIGNA Care
Network benefit plan option is offered.
"This is the time of year when
consumers are thinking about enrolling for benefits,
they want and need information to help them forecast
costs and better understand the value they are
receiving for their health care dollar," said
Dr. Jeffrey Kang, chief medical officer for CIGNA
HealthCare. "Our commitment is to not only
provide consumers with a broad range of information
on cost and quality, but to also provide personalized
support for members as they make health care choices."
The new tools are the latest addition
to the extensive cost and quality information available
to members through the CIGNA HealthCare provider
directory and the member's personalized web portal
at myCIGNA.com. For example, members can compare
hospital quality and efficiency, review prescription
drug information and compare prescription drug
costs, and research state average cost estimates
for common medical services, such as an annual
physical, well woman exam, cholesterol screenings
or blood draws and for specific health conditions
ranging from delivery of a baby to the treatment
of kidney stones.
"Employers have long called
for information transparency and, with the federal
government now embracing the need for cost and
quality information, the trend is gaining even
more momentum," states Helen Darling of the
National Business Group on Health. "Collaborations
are taking place at all levels and among providers,
policymakers, quality organizations, employers
and health plans to continue to develop standard
quality and efficiency measures and provide that
data to consumers. We support CIGNA HealthCare's
continued efforts to expand the availability of
information to their members in a manner that is
thoughtful and inclusive of standards endorsed
by the NCQA and other quality organizations."
"Combining robust marketing
and consumer intelligence with the best employees
in the gaming industry, Harrah's has achieved remarkable
business successes. Using this formula with a twist,
we hope to achieve better health outcomes for our
employees by equipping them with the information
they need to make the best choices in managing
their own health and wellness," states Jeff
Shovlin, vice president of Benefits for Harrah's
Entertainment, Inc. "The more tools and resources
we give to our employees to help them research
care ahead of time enables them to make better
decisions, improving their health thereby reducing
costs. The new tools offered by CIGNA further our
efforts to provide meaningful information to our
employees and are one of the primary reasons we
selected them to provide health benefits to our
employees."
Kang said that quality can vary significantly
among specialists and costs for an outpatient procedure
in a given area can differ by more than 30 percent
depending on the facility selected. He adds that
the goal is not only to give consumers information
but also to encourage choice based on performance
on quality and efficiency measures through benefit
plan design and member cost savings.
The expanded transparency tools include:
- Average costs by facility for outpatient
and high-tech radiology services -
effective immediately, CIGNA HealthCare members
nationally will be able to access and compare
the estimated average specific facility costs
for 16 outpatient surgical procedures that
account for a majority of all facility-based
ambulatory surgeries, such as colonoscopy,
endoscopy or cardiac catheterization. Estimated
average costs by provider for the three most
common high-tech radiology procedures, magnetic
resonance imaging (MRI), positron emission
tomography (PET), and computed tomography (CT),
will also be available. In a given market,
costs for an MRI can range from a low of $350
to a high of $1100. This information is available
on CIGNA HealthCare's personalized member web
portal, myCIGNA.com.
- Significantly expanded markets for
CIGNA Care Network benefit plan option -
available January 2007 in 58 markets throughout
the country, CIGNA Care Network benefit plans
offer a higher level of in-network benefits
for those members who receive care from a participating
specialist who has received the CIGNA Care
Network designation. Participating specialists
receive the CIGNA Care Network designation
based on their performance on select quality
and cost-efficiency measures. On average, members
can save between $10-$30 per office visit when
they receive care from a CIGNA Care Network
designated specialist through a lower co-payment
or co-insurance level. Members can still see
any specialist in the network. View a complete
listing of CIGNA
Care Network markets.
- Quality and efficiency star-based scores
for specialists across the country -
available January 2007, the Physician Quality
and Cost Efficiency tool gives one- to three-star
scores for specialists in the network based
on performance on select quality and cost efficiency
measures. The quality scores are based on National
Committee for Quality Assurance (NCQA) recognition
programs, performance on select evidence-based
quality measures derived from measures endorsed
by quality organizations including the National
Quality Forum (NQF) and satisfaction of our
board certification criteria. Cost efficiency
scores reflect a specialist's cost-efficiency
relative to peers in the same geographic area
using the Episode Treatment Groups methodology
that looks at medical costs (inpatient, outpatient,
laboratory, radiology, pharmacy, etc.) for
an episode of care and includes case-mix adjustment
to help account for differences in the severity
of patients' illnesses. The Physician Quality
and Cost Efficiency tool is available on CIGNA
HealthCare's personalized member web portal,
myCIGNA.com.
