USA – Cigna Corp has launched a new provider consult service with the goal of improving cancer patient outcomes.
The program, which is backed by the capabilities of the insurer’s Evernorth subsidiary, connects community oncologists with cancer subspecialty experts at National Cancer Institute-designated centers.
According to Cigna, these connections will allow patients to benefit from the most recent advances in cancer care while also keeping their care close to home.
In a pilot study, community oncologists had their treatment plans reviewed by experts, and in 40% of cases, patients were recommended alternative tests or treatment based on new research advances.
The program is currently available to select Cigna members, but it is being expanded to include additional members as well as clients of Evernorth’s eviCore analytics platform.
An examination of Cigna’s eviCore’s approach to automated prior authorization.
According to Bhuvana Sagar, M.D., a senior medical executive at Evernorth, the initiative is intended to ensure that patients can access these new therapies without the insurer interfering with their relationship with their provider.
The insurer was initially concerned about doc pushback, but the pilot revealed that the participating physicians welcomed the additional feedback.
Meanwhile, patients in the pilot appreciated the opportunity to have their case reviewed by an expert without having to travel, she said.
Cigna uses proprietary technology to identify members who have recently been diagnosed with complex cancers, such as certain types of colon cancer, lung cancer, or breast cancer, and who are likely to benefit from a review.
Their treatment plans are then reviewed by cancer subspecialists at one of the National Cancer Institute ‘s (NCI’s) more than 20 designated centers.
The program is intended to complement Cigna’s existing integrated cancer care model, which includes personalized case management, mental health services, and financial assistance.
Meanwhile, Cigna Corp reported a higher-than-expected first-quarter profit, boosted by growth in its health services unit, which includes the pharmacy benefits management business, and raised its full-year adjusted profit forecast slightly.
Health insurers have been put under pressure as a result of the pandemic’s volatile medical costs, some of which were offset by people postponing non-urgent medical procedures.
Evernorth, Cigna’s health services unit that has been driving growth in recent quarters, reported adjusted revenue of US$33.59 billion in the quarter ended March 31, up from US$30.62 billion the previous year.
Cigna raised its forecast for 2022 adjusted profit from operations to at least US$22.60 per share, up from US$22.40 per share previously.
Cigna’s medical care ratio (MCR), which compares the amount spent on medical claims to the amount earned from premiums, increased to 81.5% in the reported quarter, up from 80.9% the previous year, owing in part to higher medical costs.
Cigna’s income from operations, excluding special items, was US$6.01 per share, exceeding analysts’ average estimate of US$5.18, according to Refinitiv IBES data, cited by Reuters.