Cigna introduces personalized health support model
Cigna Healthcare has introduced Health Sense, a support model that combines information about members’ health, coverage, costs and previous interactions to help them handle care. The insurer plans to begin rolling it out in early 2027, initially for people with cancer and cardiometabolic conditions.
Cigna projects that Health Sense could reduce inefficient healthcare spending by 10% by 2030 by connecting members with support earlier and helping them use their benefits more effectively. The company describes the figure as a projection; it has not yet measured Health Sense’s results.
Targeting Unnecessary Healthcare Costs
“About one-third of healthcare spending is considered inefficient, driven by poor coordination, duplicative services, administrative complexity and missed opportunities to help people get care at the right time,” stated Bryan Holgerson, president of Cigna Healthcare U.S. and executive VP of customer health outcomes at The Cigna Group. Holgerson said that Health Sense was created to address those challenges by connecting health information, benefits and support around the individual, helping people get the right support sooner and make better use of their benefits.
The system will operate within Cigna’s existing platforms, including myCigna, care management tools, and clinical support services. By analyzing data, leveraging AI, and applying clinical insights, it will enable care teams to recognize potential needs and maintain continuity across member interactions.
Customized Member Assistance
According to Cigna, Health Sense aims to help members grasp their coverage options, anticipate out-of-pocket expenses, locate in-network providers, and prepare for medical visits. Consolidating this information may empower members to select appropriate treatments while avoiding superfluous or overlapping costs.
Holgerson highlighted that delayed support often disrupts care continuity, negatively affecting both treatment quality and expenses. “Health Sense is designed to create a more continuous and personalized experience by bringing together health information, benefits and clinical support,” he said.
The initiative merges AI advancements with medical expertise to forecast individual needs and deliver tailored guidance throughout their healthcare journey. “When people have a clearer picture of their options and easier access to support, they’re more likely to stay engaged in their care and achieve better outcomes,” Holgerson noted.
Broader Application of Support
Health Sense will incorporate medical, behavioral health, and pharmacy claims data—where applicable—alongside benefit details and past interactions when administered by Cigna or affiliated entities. This wide-ranging approach is intended to provide care teams with a more complete understanding of each member’s requirements.
For cancer patients, the system may facilitate connections with case managers, while individuals with cardiometabolic conditions could receive assistance in addressing medication adherence challenges. The nature of support will vary based on each member’s specific needs and available benefits.
“Data provides signals, but context gives those signals meaning,” remarked Dr. Stanley Crittenden, Cigna Healthcare’s chief medical officer. “Health Sense combines that context with clinical expertise to help tailor support to the person, the decision and the moment.”
Cigna’s medical professionals, nurses, pharmacists, behavioral health specialists, and care managers will contribute their expertise to Health Sense, though final diagnosis and treatment decisions will remain with members and their providers.
Cigna’s partnership with OpenAI to assist patients with complex conditions, beginning with cancer, further illustrates this trend. The collaboration will integrate AI into the workflows of oncology nurses and case managers at Accredo Specialty Pharmacy and Cigna Healthcare, helping them identify emerging needs and coordinate care between medical visits.
