Cigna announces new copay-centric insurance model, backed by AI care coordination
Medical insurer Cigna announced on Tuesday that it’s launching a new type of health plan, one it said is meant to bring “greater transparency, predictability and simplicity to the care experience.” The offering will be backed by the company’s proprietary AI, in this case used for price transparency—which is crucial, as these plans will be reliant on copays.
In its announcement, Cigna also stated that this copay model would be tiered, presumably by the monthly premium paid, but that all deductibles would be eliminated across all healthcare services, from lab tests to physical therapy to surgeries.
Dubbed "Clearity," the service will also be offered to employers as part of benefit packages in an effort to “support various cost-share strategies without narrowing networks or access to care.”
“Each package includes up to four in-network tiers and one out-of-network tier, and all are supported by capabilities such as patient reviews and provider insights—allowing users to surface the information that makes choosing care simpler and more transparent,” Cigna wrote in its statement.
Clearity is built on the insurer's Open Access Plus network, designed to enhance care continuity by guiding patients to a provider who will take a copay-centric plan, especially if they’re transitioning from something more traditional.
The company said all of this is supported by its AI assistant, which will help users to navigate their care options, answer questions about coverage and display accurate cost estimates. Cigna has advertised this and the broader Clearity offering as being especially beneficial to “tech-savvy” individuals who already use similar applications for care coordination.
"We designed the Clearity plan to support a wide range of people who are looking for a simpler health insurance experience,” Erin Lenox, president of national accounts at Cigna, said in a statement. ”From tech-savvy employees and healthy individuals who prefer pay-as-you-go options to those who may skip care due to high deductibles and financial barriers, Clearity by Cigna Healthcare offers a better path to care."
'Concierge' as insurance
Clearly the healthcare payer is borrowing a page here from “concierge care” models, where members pay a fee every month for certain services, then pay out-of-pocket in cash for others at a discounted rate, with nothing billed to insurance.
Major healthcare provider groups, such as Atrium and Duke Health, have adopted these models which cater to people who can’t afford the rising cost of insurance but also make too much money to qualify for government help, such as Medicaid.
Cigna said it unveiled the option in response to what it sees as market demand.
It remains to be seen how much the cost of care is reduced for Clearity customers versus those who use traditional health plans. But in terms of what a patient will pay out of pocket, that depends on the tier they’ve signed up for.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.