Cigna embraces Tableau, improves healthcare affordability and care for 95M customers

Saved $145M in total medical cost to-date with annual per patient savings of $120

Reduced opioid prescriptions by 25%

Top performing Collaborative Care participants save 3% in medical costs

Cigna® delivers affordable, quality care to 95 million global customers through commercial health, dental, life, accident, and Medicare and Medicaid insurance products. Cigna relies on data from across the organization and from its Collaborative Care program to achieve its business goals of “better health, better affordability, and better experience for patients and providers,” said Paul Van Dorpe, Business Analytics Director at Cigna.

In 2017, the company implemented Tableau as the visual analytics platform for its 550 Cigna Collaborative Care partner organizations in 32 U.S. states. Using Tableau, Cigna’s analytics team reviews financial transactions, customer and provider data, creates meaningful reports, and shares them with partnering providers so they can offer better, more affordable patient treatment. After completing its 2018 survey of providers titled “CCC Reporting Portal and Registration Process Survey,” 41 percent of respondents indicated that they use the quarterly reports more frequently to understand patient history, diagnoses, and treatments. The reports help them determine who to follow up with for appointment reminders and when, and provide information for brief health updates, medication compliance reinforcement, and post-surgery recovery documentation.

Tableau provided Cigna the flexibility to securely integrate multiple data sources with its existing data infrastructure and offer governed reports to Collaborative Care partners. To date, this has resulted in $145 million in medical cost savings, and annual per-patient savings of $120. With Tableau, Cigna also supports internal analysts who synthesize healthcare costs and data from more than 140,000 physician partners, helping keep the quality of care standards high for its 95 million customers.

Tableau-powered reports enhance patient care and affordability, guarantee data security

Relationships with primary care providers and specialists, clinics, and facilities who participate in Cigna Collaborative Care (CCC), plus the data from all of its insured customers, puts Cigna in a unique position to reveal insights for the best, most affordable treatment of patients.

Cigna previously used Excel to analyze their multiple, disparate data sets. This created confusion about performance of Cigna’s Collaborative Care participants and made it difficult for them to know if their industry-leading engagement, satisfaction, and experience levels were maintained or exceeded. Pre-Tableau, Collaborative Care providers took static legacy reports, adapted them, and sifted through data points to gain insights. But this workflow wasn’t optimal, generated low engagement, created missed opportunities and made it difficult to positively influence patient outcomes.

The analytics team audited 14 previous Collaborative Care reports to determine a go-forward strategy. “We try to build relationships with all of our ACO (Accountable Care Organization) partners by delivering new tools, and new reports that will enable them to focus on what’s really important—the health and well-being of their patient population,” explained Jo Ann Bidwell, Business Analytics Manager at Cigna. Consequently, Cigna combined financial transactions, customer, provider, treatment, and other data in Tableau dashboards that “make the complex simple, which is our guiding approach for how we provide useful information,” stated Paul.

Performance monitoring is critical for tracking quality of care—individually, as a practice, in comparison with peers—and for understanding which measures have opportunities or require focus. The provider report card that is accessible in Cigna’s secure Collaborative Care reporting portal is rooted in Evidence Based Medicine and provides valuable performance metrics. It has multiple filters—ER metrics, inpatient treatment instances, out-of-network treatments, and primary care provider-to-specialist ratios, to name just a few. Drilling into prescription patterns, for example, providers may discover new opportunities to offer generic medicine at lower cost to patients.

We build relationships with our Accountable Care Organization partners by delivering new tools and reports that enable them to focus on what’s really important—the health and well-being of their patient population.

Tableau provides Cigna with greater flexibility to support our Collaborative Care providers who benefit from on-demand, actionable data and access to analysts who study their medical cost patterns and trends, allowing them to improve care and generate cost savings for their patients. Additionally, the Tableau reporting suite can identify potentially avoidable complications related to certain procedures and the occurrence rate, thus focusing efforts on the best opportunities to improve outcomes and avoid additional future complication costs.

This level of detail, not typically found in electronic health records, provides value to clinicians, surgical groups and medical facilities, by uncovering significant cost savings for the practice that can translate into increased affordability for their patients. Other benefits made possible by Cigna's Tableau reporting include:
● Improved HIPAA compliance, facilitated by Tableau’s integration with Cigna's user-authenticated portal for reporting access
● An understanding of physician or hospital utilization patterns that lead to shared savings
● Ability to assess savings on the episode level (e.g. knee replacement, hip revision, etc. for orthopedic episodes)
● Better resource prioritization and optimization, enabled by actionable insights

The power of data really comes from harnessing so much information, finding what is truly actionable, and distilling it into insights that will be the outcomes and measures we can directly tie to actions.

Analytics help providers reduce opioid prescriptions by 25 percent

Opioid misuse and addiction is a national public health crisis that adversely affects social and economic welfare. More than 100 people die from overdoses, daily, and the Centers for Disease Control and Prevention (CDC) estimate that the economic impact of prescription opioid misuse in the US is $78.5 billion per year derived from healthcare costs, lost productivity, and treatment. Unfortunately, a serious issue arises when primary care physicians, who are unaware of patients’ treatment by other providers, write opioid prescriptions for patients who have not been identified as at risk for opioid misuse or abuse.

In collaboration with Collaborative Care partners, Cigna hypothesized that existing data could be used to better control opioid delivery. This led to the creation of the Opioid Drug Utilization report in Tableau that filters by number of patients treated per provider, the number of prescriptions written, their duration, and by date filled. The report incorporated both patients that the provider is contractually obligated to manage, as well as other patients (e.g. patients without primary care providers), since misuse and addiction reaches beyond those patients within their contractual obligations. As a result, providers now have a view into which patients are at risk or fall outside of CDC guidelines.

With this comprehensive view, Cigna provider partners decreased opioid prescriptions by 25 percent—a goal that was met earlier than planned—and Cigna now has a goal to reduce overdoses by 25 percent in key markets during the next two years. Tableau will track progress in quarterly reviews as they take action, and these efforts dovetail with the U.S. Surgeon General’s “Turn the Tide” pledge and the CDC’s opioid prescribing guidelines.

Dashboard adoption positively impacts population health

To ensure comprehensive stakeholder support, Cigna implemented two Tableau Server instances: one geared for internal analysts and management who offer consultative services to ACOs and another that is directly accessed by ACOs in the reporting portal. The analytics team monitors dashboard performance across the servers to identify training opportunities, look for areas where design changes may help adoption, and monitor how specific reports influence use.

This detailed evaluation wasn’t possible before Tableau. “We didn’t know if people used or ignored them, and how fruitful they were. Now we can track individual dashboard utilization to users and connect population health performance to how strongly providers made use of our reporting solutions,” stated Paul. As previously noted, Cigna learned that 41 percent of respondents use the quarterly performance dashboards more often thanks to Tableau’s visual format. “In fact, one of our ACO clients in North Carolina told us that the ‘more detailed, practical reporting shows us specific ways to reduce costs.,’” Paul explained.

Now we can track individual dashboard utilization to users and connect population health performance to how strongly providers made use of our reporting solutions.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company or its affiliates. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All images are used for illustrative purposes only. © 2019 Cigna. Some content provided under license. (L)