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CIGNA Expands Reporting of Its Quality Scores as Part of Efforts to Improve the U.S. Health Care System

BLOOMFIELD, Conn.-(Business Wire)-October 2, 2008 - Today, an independent organization that has for over a decade measured the efforts of U.S. health plans to improve health care quality released its annual report on the “State of Health Care Quality.” Data from the National Committee for Quality Assurance (NCQA) shows that CIGNA's health plans continue to raise the bar on quality, improving or already achieving high scores in a number of key areas such as colorectal cancer screening and childhood immunizations.

According to a CIGNA analysis of the NCQA data, CIGNA's programs have led to a greater than 25 percent (25%) improvement in key indicators of health care quality for its HMO and point of service plans over the past seven years, including a more than four percent (4%) improvement from 2007 to 2008, the single biggest year-over-year increase in four years.

This year also marks the first year that information about quality of care in PPO-type plans is being publicly reported. In 2004, CIGNA became the first national health service company to voluntarily commit to measuring and reporting to NCQA on indicators of health care quality for its PPO-type plans and has provided this information to NCQA for quality benchmarking purposes since 2006. According to CIGNA's analysis, its programs have led to a greater than eight percent (8%) improvement in key indicators of health care quality in its PPO-type plans over the past three years, including a five percent (5%) improvement from 2007 to 2008.

“While health care reform proposals may differ in their approaches, there is widespread agreement that improving the delivery of evidence-based care in the U.S. health care system is one of the most important and sustainable ways to improve health care outcomes and control costs,” said Dr. Jeff Kang, Chief Medical Officer for CIGNA. “And we know that investing in these efforts reduces costs now and prevents future costs. Our drive to improve the quality of care extends to all of our efforts, day in and day out, because better quality means better value, and most importantly, better outcomes for individuals.”

Kang said that even while the NCQA’s report shows progress in many areas, health care quality remains uneven across the health care system. For example, a 2006 study published in the New England Journal of Medicine estimated that U.S. adults receive only about 55 percent of recommended health care services.¹

The opportunity to improve quality is one of the reasons behind CIGNA's push to publicly report on its own progress and also behind its efforts to help establish a national model for physician performance measurement programs. In 2008, CIGNA was the first to have its physician performance measurement programs reviewed by a “ratings examiner” — the NCQA. Earlier this year, CIGNA also joined a group of leading consumer, employer, physician and labor organizations in endorsing a national “Patient Charter” that calls for making information about physician performance available to individuals, and independent review of health plan physician performance measurement programs. CIGNA became the first national health care plan – in 2007 – to earn NCQA “Distinction” status across all of its 23 accredited HMO and POS plans for the way it measures and provides information about the quality of physician and hospital care.

Kang said that in addition to these efforts, in the past year alone, CIGNA has launched new programs that identify ways to improve health sooner — before disease or complications occur — and that aim to improve quality by making it easier for people to get information to help gauge the quality and cost of care from among different providers. Examples include:

a health assessment to identify health risks, powered by sophisticated analytics from the University of Michigan that are exclusively licensed to CIGNA, coupled with online coaching for physical activity, nutrition, sleep and stress;
the CIGNA Well-Informed Program, which uses software together with CIGNA's integrated medical, behavioral, pharmacy and lab data, to conduct ongoing analyses to identify potential gaps or omissions in care in about 120 different categories, and then communicate with individuals and their physicians if a gap is identified;
Care Connections, which completely transformed CIGNA's conventional online provider directory from a physician and hospital lookup tool into a more comprehensive, physician, hospital and care decision support capability, integrating health information, quality information, cost of care, and questions to ask a doctor using simple, symptom-based searches. Care Connections also greatly expands cost-of-care information, delivering the ability to estimate costs for more than 400 procedures and conditions; and,
a new policy to improve hospital safety and reduce avoidable hospital errors, which is comparable to a similar policy of the Centers for Medicare and Medicaid Services (CMS). Both became effective on October 1, 2008. CIGNA’s policy focuses on quality and safety events in hospitals that can be prevented, requires hospitals to code for “never events” (errors that should never happen, such as surgical procedures that are performed on the wrong side, wrong site, wrong body part or wrong person) and avoidable hospital errors; and may involve reduced reimbursement in some cases for conditions that were not present on admission.

Just how much does improved quality save? In 2003 CIGNA developed the Quality Value Model© to demonstrate the costs savings that can be attributed to gains in quality care. The Quality Value Model is a mathematical model that quantifies the estimated savings that result from compliance with 27 of the measures of clinical effectiveness examined by the NCQA.

In calculating savings, the model estimates direct medical costs and indirect costs of lost productivity avoided because an individual received appropriate care, and compares them to the cost to comply with the measure, such as the cost of an office visit and/or certain test or procedures. Based on CIGNA's 2007 results, the total savings attributable to compliance with these evidence-based standards of care is estimated to be approximately $355 per member per year – $149 in direct medical costs and $206 in indirect productivity savings. The Quality Value Model will be updated with the newly available 2008 data.

Editor’s Note: To schedule a Webcast demonstration of Care Connections or the health assessment, contact Joe Mondy by phone at 860-226-5499 or joseph.mondy@cigna.com.

About CIGNA

CIGNA (NYSE:CI), one of the nation's leading health service companies, is dedicated to helping the people we serve improve their health, well-being and security thorough a diversified portfolio of benefits and services. Serving approximately 47 million people throughout the United States and around the world, CIGNA Corporation's operating subsidiaries offer a full portfolio of medical, dental, behavioral health, pharmacy and vision care benefits as well as group life, accident and disability insurance. To learn more about CIGNA visit www.cigna.com.

¹ New England Journal of Medicine, March 16, 2006.

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