Rooted in Health #4

At Cigna Healthcare, we’ve developed a smarter approach to care to ensure our clinical services are more relatable, impactful and easier to present to our customers, today and tomorrow.

We’ve achieved this by bringing together three essential elements:

• evidence-based clinical programmes
• simpler and smarter access to care
• expert clinical guidance

The combination of these three elements resulted in the creation of four distinct pathways to health, carefully designed to address everyday health needs and unexpected challenges:

• Core Programmes
• Women’s Health
• Men’s Health
• Mental Health

At Cigna, we believe that organising our clinical programs into clear pathways makes our clinical proposition easier to understand and more intuitive for customers and clients alike.

The heart of our approach

Our in-house clinical team is at the centre of our approach. It’s made up of a global collective of dedicated doctors, nurses and health specialists that bring deep clinical expertise and compassion to customer support. From advising on the best care pathway to providing extra support on complex cases, our mission is to ensure customers feel heard, supported and safe throughout their health journeys.

Four core pathways. One global clinical approach.

1. Core programmes: Supporting everyday health and navigating the unexpected
   We built our core programmes on deep clinical insight to support people living with chronic conditions or who are facing complex health challenges. With the aim to improve and deliver outcomes with clarity and compassion, through targeted care, expert coordination and proactive guidance. the unexpected We built our core programmes on deep clinical insight to support people living with chronic conditions or who are facing complex health challenges. With the aim to improve and deliver outcomes with clarity and compassion, through targeted care, expert coordination and proactive guidance. Here is an overview of the four core programmes that help deliver each of the pathways: Prevention and early intervention, Condition Management, Case management and Pharmacy. We will explore these further later.
2. Women’s Health: Personalised care at every stage of life
   We support women at every stage of life, from early detection and reproductive care to emotional well-being. With personalised support and trusted resources, we help women take charge of their health with clarity and confidence. The four core programmes that make up our women’s health offering are: Prevention and Early Intervention, Gynaecological Care, Family Building, Maternity and Hormonal Health, and Mental Health. You can explore these further here.
3. Men’s Health: Providing confidence when you need it most
   Our men’s health services are designed to meet unique needs across physical, reproductive, hormonal and emotional health. We focus on prevention through early screenings, personalised guidance, and flexible support that makes it easier to act with confidence. Our core programmes that make up our men’s health offering are: Prevention and Early Intervention, Family Building, Maternity and Hormonal Health and Mental Health Support. You can explore these further here.
4. Mental Health: Mental well-being made more accessible
   We provide support for everyday stress, emotional challenges and more complex needs. From coaching and short-term counselling to therapy and digital tools, we make it easier to access care confidentially, build resilience and feel supported wherever you are in the world. Our four core programmes that make up our mental health offering are: Coaching, Short-Term Counselling, Ongoing Counselling and Employer Support. You can explore these further here.

Diving deeper into the success of our Core Programmes

All of our four pathways and the programmes that sit within them are equally important and intricately linked. That’s what makes our integrated clinical approach so strong and useful to customers. It allows us to see and treat people holistically.

But in particular, recent studies are proving that our Core Programmes pathway is already having a remarkably strong positive impact on people’s health and health care costs around the world, largely through our Case Management approach.

Here’s an overview of what our Core Programmes cover, and we’ll dive into why each part is so effective:

Prevention and early interventions

Designed to help people stay ahead of their health issues by identifying risk early, providing personalised guidance and making care easier to access wherever they are. Some of the ways we do this are through preventative screenings and risk assessments, which we can then help improve their health with one of our guided health advisors.

Condition management

Designed to support individuals living with chronic or complex health conditions through personalised care, proactive outreach, and evidence-based interventions. These programmes help to improve health outcomes, reduce complications, and empower customers to manage their conditions. One example of this would be how we provide proactive and interactive coaching solutions for people with Musculoskeletal (MSK) conditions through a personalised care plan including expert guidance, exercise routines and monitoring, to help them manage ongoing pain, injuries and mobility challenges.

Pharmacy

Designed to make it easier for customers to access medications- safely, affordably and conveniently, no matter where they are. Through Express Scripts® Pharmacy, customers can receive retail and mail-order prescriptions at no additional cost, with up to a 90-day supply, automatic refills, and flexible payment options to suit their location and lifestyle. For those managing complex or rare conditions, we partner with specialty pharmacies to provide personalised medication support and care coordination. This includes guidance on proper usage, side effect management, and access to clinical pharmacists who understand the unique needs of international patients. Whether it's routine prescriptions or specialised therapies, our pharmacy services are designed to deliver peace of mind and continuity of care across borders.

And finally, our approach to Case Management is already shaping people’s lives for the better and helping to power better outcomes.

Case Management

Designed to help navigate serious or complex medical events by offering expert guidance, care coordination and advocacy. From hospital discharge planning to ongoing support, our case managers help ensure every step of the care journey is informed, supported and aligned with the customer’s needs and benefits. There are four key areas that we look at with case management:

• General and speciality case management: A case manager will support customers during and after complex health events by offering tailored care coordination and compassionate guidance, to help patients understand their treatment plans, and access resources that support recovery and long-term health.
• Pre-authorised support: Some treatments and procedures require prior approval to ensure coverage under a customer’s medical plan. Our team helps streamline this process by guiding individuals through the necessary steps, reducing delays, and ensuring they receive timely care with full benefit support.
• Utilisation management: Specialist assistance to ensure customers make the most of their health benefits, accessing high-quality care while minimising out-of-pocket costs.
• Hospitalisation Support Programme: Provides personalised clinical guidance before, during and after a hospital stay – at no additional cost. Nurse case managers work closely with our customers, their families, and their care team to coordinate care, answer questions, and support recovery. The programme helps reduce complications, improve self-management, and connect them with in-network specialists to enhance their overall well-being.

Does it work?

In a recent claims-based study, Cigna Healthcare Global Health Benefits put our Case Management to the test, to see if our core programmes actually work and the answer is a resounding ‘yes’. We analysed claims among 8,200 global Cigna Healthcare customers, including: 1,700 case management programme participants (study) and 6,500 non-participants (control), across 30 countries, with claims covering diagnoses including cancer (30%) and Circulatory (21%) and found:

Participants in our case management programme experienced better outcomes than non- participants, including:

• Optimised Health Care Utilisation – Case management participants demonstrated a shift from inpatient care to outpatient support, which could lead to fewer hospital stays and lower overall health care costs.
• Cost Efficiency – While total medical spend increased in both groups due the diagnoses and related treatment expenses, it rose by only 5% in the study group compared to 48% in the control, suggesting an improvement in the management of patient costs.
• Increased Productivity & Quality of Life – Case management participants had fewer hospitalisations than the control group, which could lead to less work disruption, often more customer convenience, and faster recovery times.

We’re proud of the positive impact our Case Management programme is having, but we’re not stopping there. You can read more about the outcomes and how we plan to continue to improve outcomes for our customers here.

Access to care made simple

We believe that the changes we’ve made to present our integrated global clinical approach will help you support your clients and their families to access the care they need, when they need it. And our core programmes will continue to have a positive effect on those who are going through a diagnosis and ongoing care.

If you’d like to find out more about any of the above, you can explore our global clinical approach here.