Cigna Expands AI-Powered Care Management Programs for Members
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The expanded initiative is expected to reach 20% more members and supports conditions including cancer, heart disease, kidney disease, high-risk pregnancy, and behavioral health conditions.
Cigna Healthcare has expanded its AI-powered care management programs, using predictive analytics to identify health risks earlier and provide personalized support to members with emerging or complex health needs.
The expanded initiative is expected to reach 20% more members and supports conditions including cancer, heart disease, kidney disease, high-risk pregnancy, and behavioral health conditions.
According to Cigna, its care teams use predictive analytics to identify individuals who may benefit from earlier intervention, helping prevent disease progression and adverse health outcomes. More than 1,250 clinicians, including nurse managers and behavioral health professionals, support members by coordinating care across providers and connecting them with services available through their health plans.
Stanley Crittenden, MD, Chief Medical Officer at Cigna Healthcare, said that as healthcare becomes increasingly complex, more personalized care pathways and support are becoming essential.
He said that identifying patients at risk of developing or worsening complex conditions earlier “will make a much more meaningful difference clinically and financially.”
Crittenden added, “We think these enhancements will bring care and support to people at the right time.”
Cigna projects that the expanded care management programs will reduce medical costs for engaged members by an average of $2,000 per year, resulting in an estimated $200 million in total savings over the next three years.
The company also reported early outcomes from the programs, including a 42% reduction in avoidable inpatient stays. The initiative accelerated the identification of potential breast, colon, and lung cancer diagnoses by 55 days, 46 days, and 37 days, respectively.
In addition, 72% of members with depression who were connected to behavioral health experts experienced a clinically meaningful improvement in their symptoms, according to Cigna.
The insurer also reported a 95% customer satisfaction rate among surveyed participants in its care management programs.
While AI powers the enhanced care management capabilities, Crittenden said clinicians remain central to the program, with members able to connect with care teams through phone, text, or digital channels.
“Ultimately, healthcare is a business of people taking care of people,” Crittenden said.
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