Skip to main navigation Skip to main content Skip to footer
  • For Individuals & Families
  • For Medicare
  • For Providers
  • For Brokers
  • Search
  • For Employers:
  • For Employers:
  • Plans and Services

    Plans and Services

  • Who We Serve

    Who We Serve

  • Employer Resources

    Employer Resources

  • Log in to Employer Portal
  • Log in to Employer Portal
  • Plans and Services

    Plans and Services

  • Who We Serve

    Who We Serve

  • Why Cigna Healthcare
  • Employer Resources

    Employer Resources

  • Home Employers Industry Insights Consumer Behavior Success Story

    Case Study | July 2015

    Consumer Behavior Success Story

    Working with Cigna Healthcare, a large Taft-Hartley Fund doubled their savings goal of $7 million—saving $15 million in three years. This union leadership’s commitment to increase member communication and engagement was the key contributor.

    The Challenge

    • Save $7 million
    • Improve the financial condition of their Benefit Trust Fund without significantly effecting member cost
    • Become better consumers of health care and be part of the solution

    Population Facts

    • 17,000 Cigna HealthcareSM customers
    • Multiple locations
    • Self-funded

    How We Did It

    In late 2011, the Fund’s plan professionals approached the Cigna Healthcare Account Team asking for advice to help improve the financial condition of their Benefit Trust Fund.

    To safeguard against effecting member costs, the plan professionals agreed with Cigna Healthcare to focus on value based plan design changes, concentrating on proven Cigna Healthcare strategies such as teaching members how to shop for more cost effective health care providers, as well as how and when to engage in the clinical support programs available to them. Initiatives under these priorities would be used to drive the necessary cost savings for the Benefit Trust Fund.

    The Cigna Healthcare team identified specific utilization pattern opportunities and provided both recommendations to teach members how to be better consumers of health care, and plan design modifications to incent members to make better health care decisions.

    Member outreach and education initiatives were implemented to address the following utilization pattern opportunities:

    • Building a relationship with a primary care physician versus self-referring to specialists
    • Urgent Care provider capabilities and locations
    • Appropriate use of the Emergency Room
    • Importance of using the newly available preventive care benefit
    • Better management of chronic conditions
    • Addressing lifestyle challenges

    A Call to Action

    The President of the union gave the membership a call to action: become better consumers of health care and be part of the solution.

    Their Cigna Healthcare client team responded to the Fund’s request for savings solutions with a number of practical actions:

    1. Add Personal Health Solutions Plus (PHS+) an enhanced utilization and care management approach.
    2. Change deductible/copay/out-of-pocket maximum.
    3. Implement Cigna Care Network® and tiered copays, encouraging visits to high performing primary care physicians and specialists.
    4. Use Cigna Value Prescription Drug List (PDL) to drive a lower cost plan to the Fund while maintaining a clinically complete pharmacy program for the membership.
    5. Modernize pharmacy plan: add Cigna Value Pharmacy, step therapy and Narcotics Therapy Management.
    6. Move to a Medicare-based maximum reimbursable charge methodology to contain out-of-network claims costs.
    7. Initiate robust communications program including specific provider steerage campaigns.

    The Power of Solidarity

    The union’s ability to leverage their trust and credibility with its membership enabled them to quickly build solidarity around how to make better health care decisions.

    By the end of 2013, the Fund had exceeded its savings goal of $7 million! Almost every plan modification generated savings. Most notable were these 2012 reductions:

    • $4 million saved with Cigna Healthcare Pharmacy Plan.
    • $600,000 saved with outpatient precertification for 1,838 individuals.
    • $2.9 million in savings with health advocacy/care management.
    • $2.4 million saved with MRC2.

    The union leaders developed and executed on a grass roots communication campaign including a list of specific actions they were asking members to take. They worked tirelessly to get the communications out through a variety of different media. The union’s plan had clear deliverables and metrics to measure the success of their asks.

    Health Advocacy and Care Management

    Cigna Healthcare is actively engaged with thousands of the Fund’s members and their families through case management, health assessments, online coaching and wellness education. PHS+ helps participants access the services most appropriate for them. Through enhanced precertification and case management, the costs to the Fund were lowered, plus their membership avoided unnecessary procedures.

    • Outpatient precertification touched over 1,800 individuals.
    • 364 unnecessary MRIs were avoided.
    • Inpatient admissions per 1,000 decreased 11%.
    • Bed days per 1,000 decreased 16%.
    • Preventive care increased.

    Cigna Care Network

    Since offering the Cigna Care Network (CCN) to active members residing in CCN service areas, CCN visits increased 250%.

    • Primary care office visits increased 4.5%.
    • Costs per specialty visit decreased 28%.
    • CCN providers represented 55% of expenses in 2012 vs. 28% in 2011.


    After the Fund implemented the Cigna Value PDL, Step Therapy, Enhanced Clinical Modules, Narcotics Therapy Management, and a change in plan design, they started to see results:

    • Generic prescription use increased from 74.4% to 83%.
    • 108 individuals were identified with multiple narcotic/controlled substance prescriptions. After intervention, costs per member dropped 51%. 43% of savings was related to medical cost savings.


    Member out of pocket costs are down, the Benefit Trust Fund is financially stable, Fund reserves are up, and members are more educated and engaged consumers of health care—which will help drive a more favorable cost trend going forward.

    Culture of wellness

    has taken root

    Healthier decisions

    among plan membership

    218% increase

    in clinical management program engagement

    $15 million

    saved in three years

    View Cigna Healthcare Company Names

    All statistics are based on a 2015 internal Cigna Healthcare client study. Individual client results will vary.

    All Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna GroupSM, including Cigna Health and Life Insurance Company and Connecticut General Life Insurance Company. The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by Cigna Intellectual Property, Inc.

    877698 07/15 © 2015 Cigna Healthcare. Some content provided under license.

    I want to...
  • Get an ID card
  • File a claim
  • View my claims and EOBs
  • Check coverage under my plan
  • See prescription drug list
  • Find an in-network doctor, dentist, or facility
  • Find a form
  • Find 1095-B tax form information
  • View the Cigna Healthcare Glossary
  • Contact Cigna Healthcare
  • Audiences
  • Individuals and Families
  • Medicare
  • Employers
  • Brokers
  • Providers
  • Secure Member Sites
  • myCigna member portal
  • Health Care Provider portal
  • Cigna for Employers
  • Client Resource Portal
  • Cigna for Brokers
  • The Cigna Group Information
  • About Cigna Healthcare
  • The Cigna Group
  • Careers
  • Newsroom
  • Investors
  • Suppliers
  • Third Party Administrators
  • International
  • Evernorth Health Services
  • Cigna Healthcare. All rights reserved.
  • Privacy
  • Terms of Use
  • Legal
  • Product Disclosures
  • Company Names
  • Customer Rights
  • Accessibility
  • Report Fraud
  • Sitemap
  • Washington Consumer Health Data Privacy Notice
  • Cookie Settings
  • Disclaimer

    Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of The Cigna Group Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT). The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by The Cigna Group Intellectual Property, Inc.

    All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna Healthcare sales representative. This website is not intended for residents of Arizona and New Mexico.

    Selecting these links will take you away from to another website, which may be a non-Cigna Healthcare website. Cigna Healthcare may not control the content or links of non-Cigna Healthcare websites. Details