Integrated medical benefits can translate to employer cost savings

Integrating medical, behavioral and pharmacy benefits under one provider can save employers$ 193 annually per employee.

A recent study from Cigna found that 22 percent more people engage in health coaching and case management programs when care is integrated. (Photo: Shutterstock)

Workers whose medical, behavioral and pharmacy benefits are “connected and administered” by a single source are more engaged in their health and well-being than those for whom those benefits are not fully integrated.

That’s according to the Value of Integration Study from Cigna Corporation, which found that not only do those with integrated benefits also experience improved health, their employers benefit, too–from cost savings.

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“A person’s physical and mental health are connected, and health care is best delivered—and produces the best outcomes—when it is connected as well,” Scott Josephs, M.D., national medical officer at Cigna, said.

The study examined approximately 4.9 million customer claims nationally from January of 2016 to December of 2017 from medical claims for group benefit plans. About half the population had comprehensive medical, behavioral and pharmacy benefits administered by Cigna, while the other half had only medical benefits with standard behavioral benefits administered by Cigna. Customers were matched between the two groups on key attributes, including demographics, health condition, access to health improvement services, plan design and geographies.

The study found that 22 percent more people engage in health coaching and case management programs when care is integrated. In addition, there was a 9 percent reduction in high-cost medical claims for customers with integrated benefits, as well as a 10 percent reduction in out-of-network claims.

Benefits to employers weren’t too shabby, either. Not only did employers experience an average medical savings of $193 annually for each covered person, and $645 annually for each person with a known health improvement opportunity, they also saw annual medical cost savings of $9,792 for engaged customers with a specialty condition, such as multiple sclerosis or rheumatoid arthritis. When people being treated for diabetes were engaged, the savings totaled $5,900.

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