CIGNA Well Informed – Information for Bridging Gaps in Care: "The CIGNA Well Informed program is designed to provide information to physicians and their patients about health risks patients may have or preventive treatments they may need. By analyzing information such as medical and pharmacy claims data and laboratory results, the program will identify specific patient health issues and concerns and will send this information to both you and your patients.
CIGNA Well Informed uses evidence-based care guidelines to identify gaps for prevalent conditions in care patterns, disease management, medication adherence, national standards of care, and patient safety. Using these guidelines, it is possible to evaluate physician treatment patterns at the patient level, and patient adherence with their physician's recommended care.
The Well Informed program is intended to support care management efforts by helping to:
Increase patient compliance with your treatment plans
Increase preventive health activities
Support you in managing chronic disease
Prevent potential adverse drug reactions and avoidable medical errors
Inform you of prescriptions and services your patients receive from other physicians that could impact your treatment plans
Alert you to potential divergence from common standards of care
Bring together disparate pieces of clinical information
Encourage patients to be involved and informed about their health status
Flag potential urgent patient health issues and/or concerns"
As a healthcare provider and Cigna insurance carrier, I do not like this program at all and have requested to opt out from both the receipt of materials from Cigna as well as the review of my insurance claims.
My physician is in charge of managing my medical care. My insurance is in charge of providing me with medical benefits to offset the cost of my health care. My insurance is not in charge of providing individualized healthcare or to supervise my physician's treatment for me. There are state and federal laws as well as licensing boards who are in charge of this and whose express purpose is to protect the public with no financial conflict of interest.
In addition to my belief that Cigna is overstepping its bounds by providing individualized healthcare advise, they are doing so when they also have much to gain financially from this. The potential financial benefit to Cigna is not mentioned in the letter; instead it highlights Cigna's interest in improving my health. With this unspoken benefit, the letter comes off as being more than a little disingenuous.
Although it can be argued that the Medical Director, Dr. Nemecek as an M.D., has been trained to put patient health first, he also has an M.B.A. I fully understand Cigna's need for a Medical Director who has training and expertise in both medicine and business. However, I do not need someone with this kind of background to oversee a department that reviews my individual medical care.