It has become clear to me that some health insurance companies have decided to try to control some aspects of healthcare delivery as a cost-saving measure. Evidence of this trend was the recent decision by Cigna to partner with CVS' MinuteClinics. This new program applies only to Cigna's employer-sponsored health plans. (see: Cigna teams with CVS Health in collaboration to rival urgent care clinics). Below is an excerpt from the article:
In June,...[Cigna] and CVS Health announced the initiative [to partner with CVS] for Cigna's self-funded employer-sponsored health plans. Retail pharmacies are competing against traditional providers by offering convenient walk-in clinics....Roughy 45 percent of urgent care facility visits by its members could be conducted at retail clinics, potentially reducing healthcare costs by 81 percent per visit, Cigna said. The collaboration aligns Cigna-administered health benefits with CVS Pharmacy and CVS MinuteClinic retail healthcare services....Cigna Health Works can help patients who do not have a primary care doctor to find one by providing a list of Cigna-contract physicians from the health plan's provider network....Cigna Health Works beneficiaries get personalized pharmacy support through Health Tag Messages on the prescription bag to advise patients of needed health actions by the pharmacist or clinician, and provide information on available Cigna health and wellness coaching services included in their Cigna plan at no additional cost. They get contracted discounts at CVS MinuteClinic for select preventive and acute care, including biometric screenings for blood pressure, cholesterol and blood sugar as well as diagnosis and treatment for minor illnesses such as bronchitis, ear infections and strep throat.
I think that the most important idea in this quote is the following: roughy 45 percent of urgent care facility visits by its members could be conducted at retail clinics, potentially reducing healthcare costs by 81 percent per visit. This initiative is one attempt by Cigna to "bend the healthcare cost curve" by encouraging insured members to seek some of their primary care at MinuteClinics. It will be a much longer and harder road to greatly reduce costs in hospitals with them trying to secure their own financial stability and also their orientation toward fee-for-service rather than value based-care. I suspect that Cigna will have much more control over costs working with walk-in retail clinics with their relatively simple business plan and care administered by nurse practitioners (NPs).
The article cited above lists some of benefits for consumers with Cigna's employer-sponsored health plans such as a discount for preventive and acute-care services. It's obviously a financial benefit for Cigna to cover the lower cost of the CVS clinic visits as well as spend more time on preventive measures and the performance of some simple lab tests. As I have said before, look for an expansion of the lab test menu performed in MinuteClinics (see: Details about CVS' MinuteClinic POCT Strategy). One initiative not yet attempted will be to enable the CVS nurse practitioners to perform blood draws with send-out tests sent to reference labs such as Quest or LabCorp. This could be accomplished today in those states where a physician order is not required for a lab test. As MinuteClinics prepare to address more serious conditions, such lab testing could be built into the diagnostic protocols used by their NPs.
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