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Points of Light 2024 Case Study 21
Leveraging AI-Driven Personalization & Virtual PCPs to Modernize Member Engagement & Risk Stratification Accuracy
Author
Boyd Stewart
Author
Aurene Wilford
Due to changes in the health plan market, Cigna Healthcare’s membership unexpectedly increased from 350,000 members to 1 million members. In order to ensure appropriate care and reimbursement, the payer organization had to quickly assess, engage, and offer care options to these new members. Cigna worked with MDLIVE and N1 Health to proactively reach out to members with a help-first approach and schedule annual wellness visits for them, ensuring that the members received the right care and that the payer organization was properly reimbursed.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved through Collaboration
- Lessons Learned—What Best Practices Can Other Organizations Replicate?
- What's Next?—Vision for the Future
Writer
Natalie Hopkins
Designer
Jess Wallace-Simpson
Project Manager
Joel Sanchez
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.