Cigna Is Using AI to Intervene Earlier in Care

Cigna is leveraging artificial intelligence to detect patients who require assistance before their health deteriorates, aiming to reduce healthcare expenses by approximately $200 million over a three-year period, as announced in a July 23rd press release. This expansion will cover 20% more customers dealing with conditions such as cancer, heart disease, kidney disease, and high-risk pregnancies, with over 1,250 Cigna clinicians utilizing AI insights to address health needs promptly.

Bryan Holgerson, president of Cigna Healthcare U.S., expressed the company's strategy to prevent unnecessary hospitalizations, better manage chronic conditions, and lower the likelihood of more severe and costly health events later.

The existing version of this program has demonstrated promising outcomes, with patients who engage early experiencing a 42% reduction in avoidable hospital stays. Cancer screenings facilitated by the program detected breast, colorectal, and lung cancers an average of 55, 46, and 37 days sooner, respectively. Additionally, 72% of customers connected to behavioral health providers achieved clinically significant improvements in depression symptoms.

Participants are projected to save around $2,000 annually in medical costs, which forms the basis of the company's projected $200 million savings over three years.

Simultaneously, Cigna's health services division, Evernorth, launched a $100 million AI initiative called Pharmacy Forward, designed for its specialty pharmacy business, Accredo. This program aims to halve the time between prescription and medication delivery, reduce clinician paperwork by up to 50%, and ensure that 90% of patients receive their medications within a one-day shipping radius, according to a July 1st press release.

The initiative is anticipated to generate roughly $400 million in value by 2028, with Matt Perlberg, president of Evernorth's pharmacy and care delivery businesses, emphasizing Cigna's commitment to providing patients with a faster and more seamless experience while ensuring personalized support and clinical care.

Moreover, Cigna's AI-powered summarization tool has reduced note-taking time by up to 90% for clinicians using the company's MDLIVE telehealth service, as reported by Katya Andresen, Cigna's chief data, digital, and AI officer, in a recent Fortune article. Cigna has also employed AI to guide patients towards more affordable alternatives for expensive biologic drugs, resulting in over 80% of targeted customers switching to cheaper biosimilar options.

The switch led to significant savings, with Humira, a targeted biologic costing approximately $7,000 a month, contributing to notable margin improvements and savings for patients. Cigna measures the effectiveness of AI by its impact on patient care and associated costs, rather than just task automation. This strategy aligns with a broader industry trend, with 84% of healthcare firms expecting to increase their AI budgets over the next 12 months, according to a PYMNTS Intelligence report.

The report also revealed that 84% of healthcare firms already utilize AI extensively in their data and technology processes, with high confidence in its effectiveness across various functions.