Cigna Pathwell Bone & Joint®
We help guide your employees to the right care at the right time, resulting in a positive impact on health outcomes—and lower costs for you.
Plans offered by Cigna Health and Life Insurance Company
Cigna Pathwell Bone & Joint – A New Standard of Care for Musculoskeletal Conditions
One of the most significant health challenges in the U.S. is the rising prevalence of Musculoskeletal (MSK) conditions, which is one of the top medical spend categories for employers.1 Unfortunately, the MSK condition care journey can be fragmented, and interventions may reach customers too late, causing a ripple effect of inflated costs, ineffective treatments, and unnecessary surgeries.
Cigna Pathwell Bone & Joint, a condition-specific care program, helps employees with spine, hip, knee, or shoulder pain get on the right treatment path, avoid unnecessary surgeries, and reduce your organization’s spend.
Employees will have access to designated providers who meet quality and cost criteria, a clinical navigation experience supported by a Clinical Care Advocate2 who helps them make the right decisions about their care, and benefit design that rewards customers for optimal care choices.
About Cigna Pathwell Bone & Joint
Get Ahead of High Costs
Using predictive models, we can help identify customers at risk for spine, knee, hip, or shoulder surgery up to one year in advance3 and proactively reach out to encourage enrollment in the Pathwell Bone & Joint program to help arrange proper support.
Clinical Care Advocate
A Clinical Care Advocate will work 1:1 with your employees via digital messaging and/or phone. Based on insights and assessment responses, they will customize the program to each employee’s unique needs, all while guiding, motivating, and encouraging their success.
Digital Guidance and Engagement
We help employees take greater control of their MSK pain with our guided digital experience. Powered by insights and evidence-based guidelines, the digital experience includes personalized activities, assessments, content, treatment guidance support, care navigation tools, and more.
The Right Care at the Right Time
When care is needed, we help connect your employees with top-tier, in-network providers (either in person or virtually) and help optimize available benefits. Employees also have access to programs that may support their medical, behavioral, or lifestyle needs throughout their MSK journey.
Surgery Benefit
If faced with surgery, a Benefit Specialist can help employees understand how to qualify for the zero or low-cost surgery benefit4 and travel benefit5 along with pre- and post-surgery support. Employees will have access to designated, in-network orthopedic surgeons and neurosurgeons that meet rigorous Cigna Healthcare℠ affordability, quality, volume, and outcome selection criteria.
Ready to learn more about Cigna Pathwell Bone & Joint?
Contact your Cigna Healthcare representative to begin.
About Cigna Pathwell
As the health care needs of our clients and customers continue to evolve, so do our solutions.
Cigna Pathwell℠ is a set of solutions that help provide the best path forward to wellness, enhancing every step of the customer journey to clarify, streamline, and personalize care, moving businesses down the path of continued growth.
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1 Cigna Healthcare book of business 2022 analysis for 2021 full year medical and pharmacy claims
2 These care advocates are nurses and physical therapists holding a current licensure in a minimum of one state but do not practice nursing or physical therapy or provide medical advice in any capacity as a care advocate.
3 Based on proprietary Cigna Healthcare algorithms, data and claims analysis to assess potential health risks. Timing and results may vary.
4 When program participation requirements are met for covered surgeries. For non-HSA plans, the employer’s plan pays 100% of eligible expenses. For HSA plans, plan pays 100% after deductible is met.
5 For surgery with designated provider >60 miles from home. Amount varies based on factors such as treatment plan, location and duration of facility stay and subject to program participation requirements.
6 Clinically Speaking: The Health Care Total Cost of Musculoskeletal Conditions, Evernorth August 2022; https://www.evernorth.com/articles/clinically-speaking-health-care-total-cost-musculoskeletal-conditions.
7 Evernorth Research Institute, MSK in the USA report, 2022
8 2023 Cigna Healthcare study of risk adjusted total medical costs by behavioral health and chronic condition using claims based on 12 month period for 1/1/2022 – 12/31/2022 for customers with continuous medical, pharmacy, and behavioral eligibility.
Product availability may vary depending on location and plan type and is subject to change. All group insurance policies and benefit plans contain exclusions and limitations. For costs and complete details of coverage, contact your Cigna Healthcare representative.
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT), or its affiliates. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).
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