Choosing the Right Location for Health Care Services

Article | June 2021

Choosing the Right Location for Health Care Services

Where you choose to access care matters when it comes to quality and cost

It’s no surprise Americans spend a lot of money on health care each year, but just how much is a lot? In one year, a typical family of four can expect to pay approximately $28,000.1 The impact to families, to employers and health plans, and to the country is astronomical. In fact, total U.S. spending on health care is projected to reach $6.2 trillion by 2028, growing at an average annual rate of 5.4% for next seven years.2

Finding opportunities to make health care more affordable is an urgent need for us all, and where you, as an individual, choose to get care can have a big impact. For example, customers have a wide variety of options for visiting with their in and out-of-network health care providers, ranging from a virtual visits (video or phone),  in-person office visits, home visits, urgent care settings or emergency rooms, but each option has implications for both quality and cost.

Below Cigna chief medical officer Dr. Scott Josephs answers questions about finding the most effective sites of care for your health care needs.  

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How can people save money on health care costs?

Making informed health care choices is the number one way people can save money. At Cigna, we empower people to “know before they go” and make more informed health care decisions based on both cost and quality. Cigna customers have a variety of tools to help them identify the most convenient, clinically appropriate and affordable services including myCigna.com, Cigna One Guide® and our best-in-class 24/7/365 customer service. 

Customers also have online access to the myCigna® directory, which allows you to search for health care professionals in our national network; search for specific procedures and compare cost estimates by location; search real-time drug prices at participating pharmacies nationwide; find less costly care alternatives and review quality-of-care ratings.

Using these tools, customers can determine what they can expect to pay out-of-pocket at the time of service as well as their total cost of care. By choosing high quality health care providers at the most appropriate location in the Cigna provider network, our customers have peace of mind knowing they are receiving care that will result in a better patient experience with lower out-of-pocket costs.

How does Cigna help you identify in-network providers for services?

As health care rapidly evolves and new treatments and care plans are developed, quality care and safety remain our top priorities. Cigna’s clinical programs are based on evidence and include a rigorous process for evaluating providers on both their performance and cost effectiveness. The most effective providers can earn a Cigna Care Designation, which is noted in the cost estimator tool on myCigna.com when a customer is searching for care options.

How do we help customers who need complex care?

For more complex care like when someone is diagnosed with cancer, a specialty care team identifies personalized options for customers and helps navigate them through the care, offering support along the way. One example is our specialty care options program where our customers are able to receive coverage for specialty medications in a more convenient, high-quality location such as a doctor’s office or even home.

What else is Cigna doing to make health care more simple, affordable, and predictable for its customers? 

Cigna seeks out innovative partnerships to drive even greater affordability. An example of this is in Connecticut where Cigna recently introduced a new orthopedic care initiative, the surgical treatment and support program, in collaboration with St. Francis Hospital, the Connecticut Joint Replacement Institute, and Southern New England Health Care Organization (SOHO HEALTH). For this program, all of the care the patient needs - whether for a hip or knee replacement, or another orthopedic surgery - is covered at one fixed price, determined and known ahead of time, also known as a prospective bundle.3

As health care continues to evolve, we remain committed to ensuring Cigna customers have access to high quality care at an affordable price.

Dr. Josephs recently appeared on an EBRI webinar discussing site-of-care and affordability. Watch the full webinar here.

1. 2021 Milliman Medical Index

2. NHE Fact Sheet | CMS

3. Cigna also offers prospective bundled payments for orthopedic care in Colorado, Florida, Missouri, North Carolina and Tennessee, and expects to bring the program to additional markets in the future.