Cigna targets ‘inefficient’ spending with clinical support model rollout

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Cigna Healthcare is launching Health Sense, a tailored customer and clinical support model that unifies health, benefits and cost information, in early 2027.

Health Sense will be embedded across the Cigna experience, instead of operating as a standalone resource. The model will bring together member context, surface that context to Cigna clinical and care teams working in collaboration with a treating provider, and help members navigate next steps. This includes preparing for appointments, reviewing expected costs and searching for in-network care. Cigna said Health Sense will not substitute treating providers, and it will not offer diagnoses, prescriptions or modified treatments.

The company is projecting that by 2030, Health Sense will reduce inefficient healthcare spending — driven by redundant or unnecessary care, administrative issues, limited coordination, and missed chances to help people access care at the appropriate time — by 10%. The company said about one-third of spending in healthcare is inefficient.

Cigna said member engagements build on each other, allowing an adaptive experience rather than isolated interactions. A Cigna demo showed how members can use a talk or text chat function to express concerns, such as an emerging symptom. This information could be relayed to a medical professional, and the member can agree to a phone call for further discussion.

Research commissioned by Cigna’s health services business, Evernorth, showed that six in 10 Americans are not confident they understand all of their benefits offered through their employer or health plan. More than half of Americans find navigating care, benefits and vendor offerings frustrating.

Customers with oncology and cardiometabolic needs will be the first to access the model. Cigna anticipates expanding Health Sense to others in the future as it monitors outcomes.

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