Global customer study makes a strong case for case management

In a recent Cigna Healthcare customer claims-based study, Cigna Healthcare Global Health Benefits put its clinical case management services to the test to illustrate their impact on customer health – and health care costs – around the world. The results speak for themselves.

Navigating the health care system during a serious or complex medical event, such as cancer treatment or major heart surgery, can be overwhelming for anyone. Add to that the uncertainty of doing so outside of one’s home country, and the impact can be detrimental – on health outcomes and health care costs, for individuals and their global employers alike. That’s because these uncertainties can often lead to inappropriate or inefficient care when it’s needed most. 

Case management programs are designed to ease this burden by offering individuals expert clinical guidance, care coordination and advocacy, helping to ensure they receive the right care at the right time. The question is: Do they work? In a recent claims-based study of Cigna Healthcare customers around the world, we put this very question to the test with our own integrated global case management program. And, based on the preliminary results, the answer looks promising. Let’s take a look.

Cigna Healthcare Global Health Benefits: Value of Case Management study¹ snapshot

Who

The 2024 study analysed claims among 8,200 global Cigna Healthcare customers, including:

• 1,700 case management program participants (study) 
• 6,500 non-participants (control)
• Men and women, ages 18+
• Multilingual content
• Customers with coverage for at least 12 months, including six months prior to enrollment in/eligibility for the case management program 

Where

Cases were geographically dispersed across more than 30 countries, with the top five countries including:

• Kenya
• Germany
• Thailand
• Switzerland
• United Kingdom

Why

Claims featured 20+ diagnoses, with the most common being cancer (30%) and circulatory (21%).

Distribution of Diagnoses *

 

Key findings

Our study results suggest that participants in our case management program experienced noticeably better outcomes than non-participants, including:

• Optimised Health Care Utilisation – Case management participants demonstrated a shift from inpatient care to outpatient support, which could lead to fewer hospital stays and lower overall health care costs.
• Cost Efficiency – While total medical spend increased in both groups due the diagnoses and related treatment expenses, it rose by only 5% in the study group compared to 48% in the control, suggesting an improvement in the management of patient costs.
• Increased Productivity & Quality of Life – Case management participants had fewer hospitalisations than the control group, which could lead to less work disruption, often more customer convenience, and faster recovery times.

What's next? 

At Cigna Healthcare Global Health Benefits, we’re proud of the positive impact our case management programs have on our global customers. However, we’re also committed to growing that impact, year after year. Part of doing so means gaining a deeper understanding of what’s working best and what could work better. As such, we’ll continue to refine our study by:

• Adding further controls, such as country of treatment, in order to account for variations in cost of care
• Drilling down further to ensure we are matching complexity and severity of each disease or condition (Stage I or Stage II cancer)
• Considering separate categories to account for hospitals and providers levels of cost (private versus public or academic medical centers)

We look forward to sharing these results as they become available. In the meantime, to learn more about our full clinical care offering, visit our Clinical Solutions page

 

Source

1. 2024 Cigna Healthcare Global Health Benefits Value of Case Management claims-based study