Cigna is expanding artificial intelligence tools designed to identify patients who need help before their conditions worsen.
The effort is projected to cut medical costs by about $200 million over three years, Cigna said in a July 23 press release.
The expansion will reach 20% more customers with conditions including cancer, heart disease, kidney disease and high-risk pregnancy, with more than 1,250 Cigna clinicians using the AI’s findings to address health needs sooner, the release said.
“As costs for hospital care, emergency services and prescription drugs continue to rise, we are investing in tools and clinical programs that help customers avoid unnecessary hospitalizations, better manage chronic conditions, and reduce the likelihood of more serious and expensive health events later,” Bryan Holgerson, president of Cigna Healthcare U.S., said in the release.
Cigna’s existing version of this program already shows results, according to the release. Patients who engage early have seen a 42% drop in avoidable hospital stays. Cancer screening under the program caught breast, colorectal and lung cancer an average of 55, 46 and 37 days sooner, respectively, than they otherwise would have been found. Additionally, 72% of customers connected to behavioral health providers saw a “clinically meaningful improvement in depression symptoms.”
Patients who take part are projected to save about $2,000 a year in medical costs, the basis for Cigna’s $200 million estimate over three years.
AI Is Speeding Up How Prescriptions Get Filled
Cigna’s health services division, Evernorth, launched a $100 million AI program called Pharmacy Forward for its specialty pharmacy business, Accredo, according to a July 1 press release.
Pharmacy Forward aims to cut the time from prescription to medication in half, reduce clinician paperwork time by up to half, and get 90% of patients within a same-day or one-day shipping radius, the release said. The program is expected to generate roughly $400 million in value by 2028.
“Pharmacy Forward reflects our commitment to meet patients where they are, delivering an even faster, more seamless experience while ensuring they receive the personalized support and clinical care they deserve,” Matt Perlberg, president of the Evernorth Health Services pharmacy and care delivery businesses, said in the release.
Meanwhile, Cigna’s AI-powered summarization tool has cut note-taking time by up to 90% for clinicians working within the company’s MDLIVE telehealth service, said Katya Andresen, chief data, digital and AI officer at Cigna, according to a Wednesday (Aug. 26) Fortune report.
Cigna Is Also Using AI to Steer Patients to Cheaper Drugs
Cigna has used AI to study past customer conversations about expensive biologic drugs and their cheaper biosimilar alternatives, then rewrote its outreach based on what worked, the Fortune report said. More than 80% of targeted customers switched.
Humira, one of the biologics Cigna targeted, can cost roughly $7,000 a month.
“That led to a lot more margin,” Andresen said, per the report. “But more importantly, it created a couple hundred million dollars of savings for patients.”
Across all efforts, Cigna is measuring AI by whether it changes what care patients get and what it costs, not just by how many tasks it automates. That shift lines up with a broader industry trend.
The PYMNTS Intelligence report “Enterprise AI Gains Ground, but Scale Remains Uneven” found in August that 84% of healthcare firms expect to increase their budgets for new forms of AI over the next 12 months, including 16% that expect increases of more than 15%, and 68% that expect increases of 5% to 15%. The remaining 16% said they expect spending to stay about the same, and none said they expect to cut their AI budgets.
The same report found that 84% of healthcare firms already report broad or embedded use of new AI tools in their data and technology processes, trailing financial services at 95% but ahead of media companies at 81%. Healthcare firms were just as confident in the results, as 95% called new AI very or extremely effective in the functions where they use it, tying financial services and outpacing media firms at 86%.
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