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Compare and Contrast CIGNA's and General Electric's Approach to Disease Management. What's the Difference... Really?

Posted Feb 08 2010 6:26am
After reading the latest CIGNA earnings call transcriptthe Disease Management Care Blog couldn't help thinking some more about the Business Week (BW) faux exposé of the disease management (DM) industry.

CIGNA seems to have had a very good year thanks to a total income of $1.1 billion or earnings of $3.98 of per share. This represents an impressive 16% increase compared to last year. Not only have their capital levels been clawing their way back to healthy levelsbut the insurer has also been tackling overheadincluding a reduction of $100 million in its healthcare operationswhile simultaneously providing a 24/7 service model with 'a broad portfolio of capabilities to achieve health improvementincluding risk identificationlifestyle and wellness programsincentivescoachingand engagement services.' Armed with a motto of 'Go DeepGo GlobalGo Individual,' the company said that '(t)here is no question (that)regardless of what happens with US healthcare reformthere will be more individual accountability for health and healthcare. So "Go individual" is a fundamental philosophy as well as part of our growth strategy.'

Critics of DM would probably say that CIGNA's commitment to the principles of DM described above isn't based on proofbut to unsophisticated market demand. Yetthere is still a telling contrast between CIGNA's many 'believing' customers versus the experience of General Electric that was described in BW. If many pilots and trials of DM are conducted in multiple settingsa distribution of outcomes is pretty much guaranteed. Is the one company's experience with DM described by BW typicalor a statistical outlier? The DMCB can't tellbut has learned to distrust the media's ability to distinguish between the two.

The faultfinding BW article ends with a description of a curious decision by GE
This springGE will start an outreach service that shares some elements with traditional disease management. Nurses will use claims data to identify gaps in caresuch as unfilled prescriptions or missed checkups. But rather than just contacting patientsthe nurses will also call the treating physiciansif patients agree....

What about the company's pronouncement that its experience with DM was a failure? It's more likely thatmuch like the rest of the DM industrythere is ongoing innovationbuilding on the lessons of what has worked and what doesn't work. Much like CIGNAit appears GE appears to have a commitment to population-based care management that includes remote nurse coaching. Does that include what BW portrays as foolish DM? You be the judge.

In the meantimegood for CIGNAgood for GEgood for the DM industry and most of allgood for the momsdadsgrandparents and all the American workers and dependents that are lucky enough to be insured by CIGNA or to be working in companies like GE.

Let the evolution continue.

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