If you have an individual with a chronic disease, say asthma, you can have a program that is passive: If they want to enroll in a care management plan, they can. Or they can be incented to enroll. Or you can have a plan that is binary: If [you] have that [condition] [you] have to be in that [care management] program. Those are all choices. What we know is if [a patient is] asthmatic and more actively managed, the health outcomes and therefore the affordability can be quite different. This is a case where if you have a chronic illness, you need to be in a management program. We know the quality outcomes will be better and cost outcomes will be more sustainable.
In late December, Cigna will stop paying brokers commissions if they sell gold-level individual plans, which cover more costs than do the less expensive bronze and silver level plans. What is Cigna’s concern with gold products?
Adverse selection. [It’s not that policyholders] are necessarily older or sicker. The whole way the benefits are configured and the way marketplace is working – the performance of those plans – is much less reasonable than all the other plans.
Either there will be more flexibility to configure them in a way to make them sustainable or there won’t be gold plans.
So is Cigna staying in the market?
We’re in for 2016.
How about 2017?
We haven’t made a comment relative to 2017. We view 2014, 2015, and 2016 as version 1.0.
Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry K. Kaiser Family Foundation.