Hello, everyone. This is Jacob Emerson with the
Becker's Pay Your Issues podcast.
Thrilled today to be joined by Dave Verkani,
who is the vice president of innovation, market
insights, and communications
within Cigna Healthcare's dental and vision business. Dave,
thanks so much for taking the time to
be with me on the podcast today.
Great. Thanks, Jacob. Appreciate the the time and
opportunity to be here. Absolutely. And, Dave, before
we dive into everything we wanna talk with
you about, can you first tell us a
little bit more about yourself, your background in
health care, and what it is that you
do today at Cigna?
Sure. So I've been with Cigna for twenty
three years, hard to believe. Came from the
financial services industry before moving to health care.
And, part of my current role, which as
you mentioned, is leading innovation and market insights
for our dental and vision business,
I held roles different leadership roles in marketing,
in business development,
market research, provider,
strategy,
and affordability
strategy in lots of different businesses across the
Cigna portfolio. So, fairly broad health care background.
Fantastic. Well, Dave, like I said, we appreciate
you taking the time to sit down with
us. And I I wanna dive right in
by talking about,
an initiative that Cigna just announced,
recently,
expanding access to flexible dental payments to 2,800,000
more of your members.
So for our listeners who might not be
familiar with what exactly is happening here, can
you give us a breakdown of of how
you're achieving this, what you're hoping to to
achieve, and what your timeline has been here?
Yeah. Happy to.
The goal behind the program that that we're
talking about
today is Cigna really was looking to figure
out ways we could improve people's health by
removing cost as a barrier to getting needed
care. So even though somebody might have coverage,
they might have insurance, it doesn't mean that
they can necessarily afford to use their benefits
all the time.
And we wanted to make sure we could
find ways to help people remove that barrier
and get the most out of their benefits.
So this initiative is a partnership with
a company called Patient.
And as part of our market launch,
we've launched patients employer sponsored benefit. And the
the basic way it works is it it
provides employees
with an on demand credit line that they
can use to pay for out of pocket
health care costs.
And it's got really flexible
repayment terms with, this is was really important
to us. No interest or fees to the
the consumer or customer or or member,
whichever term you wanna use. We wanted to
make sure this wasn't putting potentially some additional
burden
on them by requiring them to actually pay
credit card fees. And, as is mentioned, it's
an employer sponsored benefit, so employers are choosing
to offer this
to their employees
and decide which health care cost,
categories are covered and can also determine things
like the credit line that they're offering, and
repayment terms. And I think we also importantly
before we talk about kind of the expansion
here
is,
from the employer perspective,
they don't take on any credit risk.
Patient actually takes on the full financial liability
on collected payments. So there's some protection for
both the employer
and the employee. And the last kind of
benefit I mentioned in terms of things we
were looking to get out of this kind
of program,
we're very focused on the health care providers,
the dental providers in our network, and our
relationships with them. They're the ones who actually
deliver care to our customers,
and and this also benefits the providers in
the sense that it helps
reduce bad debt or challenges in collecting patient,
payment responsibility.
I appreciate you taking us through that, Dave.
And so this is an existing partnership. You've
you're now expanding it.
Let's get to the core of what I
think a lot of our listeners will be
curious about, and it really is how is
this improving access to preventive care, to critical
dental procedures for your members,
and what are some of the impacts you've
seen already, you expect to see, in terms
of member satisfaction and, of course, health outcomes?
Sure. And maybe, Jacob, before I jump into
that, I should probably mention something that is
relevant to, I think, you know, some of
the press releases and things that led to
this, you know, podcast in the first place.
So
we launched this initially as part of a
pilot in 2024
to our national accounts business segment, which is
very large employers with more than 3,000 employees.
And and the more recent news is that
we've made it available to our middle market
segment, think mid sized employers
with between 503,000
employees. So now with that expansion,
we've actually now got across our book of
business,
13,000,000
of our covered individuals, our customers
nationwide who are actually eligible for this this
program. So,
I could talk a little bit about the
the impacts. We wanted to make sure, you
know, the the potential scope of where this
is available was was, was clear as well.
Absolutely. No. I appreciate you clarifying that. So
13,000,000 members now eligible,
for this program. But, Dave, I'll let you
continue in terms of, what what it's achieved
so far in terms of metrics.
Sure.
You know, when you look at again, our
goals were behind this program.
If you look at, the opportunity to prevent
oral health issues because this as I mentioned,
this started with our dental, you know, product.
We've kind of expanded it beyond that. But,
by preventing oral health issues
that people might have,
those can really lead to much broader systemic
problems.
For example, gum disease has been linked to
lots of other serious health issues like heart
disease and diabetes,
or people showing up in the emergency department
to treat, dental pain and infection. That's a
really inefficient and very expensive way to to
address dental pain.
And those are some of the reasons, you
know, why we were motivated to do to
do this, as well as just helping people
use their benefits more effectively.
And,
when you look at our own
launch here,
we basically have had some pretty,
encouraging results. So
when you think about
out of pocket costs for essential dental services,
things like, you know, a crown or a
root canal can exceed the typical
1,500
to $2,000
annual dental benefit cap that is is very
common in dental insurance.
And that can lead people to delay or
or even forego care altogether, which we're absolutely
trying to avoid. And cost is the number
one reason
that people actually avoid dental visits.
In fact, forty percent of adults
in survey, I think, was from last year,
identified that they had skipped dental care or
routine checkups in the past year because they
actually had financial concerns. So when we look
at our results
from our launch so far, we've seen a
measurable increase in both preventive care usage and
critical dental procedures as well.
And also seeing really just, I think, good
levels of engagement in the patient program
overall,
across
the clients that we have on the program
currently.
We've got a sign up rate of
nearly 20 on average, so about 20% are
actually signing up for the patient benefit.
About 11%
of the eligible employees are actually activating,
the patient,
Visa card.
And nearly 70% of the people who activate
the card are actually making transactions on the
card. So we're we're seeing, first of all,
people engaging with this with the with the
solution and using it the way we we
want them them to. And, actually,
other data point that I think is actually
really important is of the people that that
had a transaction on the card, it wasn't
a one and done
thing. Ninety percent, of those people actually had
a repeat transaction, so they were continuing to
use it for ongoing care, which is really
important.
And
from a from a just a care improvement
perspective,
among the users of the the patient,
card,
our data analysis that we did in conjunction
with patient shows a measurable increase in both
preventive care,
as I mentioned, I think, and also critical
dental procedures.
And most frequently, that's things like fillings, crowns,
and oral surgery, so the more expensive,
procedures, which is what we were looking for.
And this might be, kind of one of
the the the stats that I was most
encouraged by. We did a survey
of SEGI customers who are using patient, and
ninety three percent of them
actually said they would have skipped care
if they didn't have access to the patient
card, which is, you know, exactly the type
of behavior we were hoping to to to
influence.
So, you know, really encouraging, I think, in
terms of early results.
We're also seeing really high satisfaction with with
the patient program.
We've got a net promoter score of 83,
which in, you know, the health care industry
is extra extremely high and, 4.9
out of five
rating on Trustpilot from all the reviews that
people actually posted online. So, you you know,
across the board, actually quite encouraged by, by
the results so far.
Absolutely. So based off everything you just said,
some of those numbers you cited there, Dave,
this model is clearly demonstrating measurable increases in
preventive and critical care utilization.
So then I wonder, you know, how how
do you see this driving long term cost
savings for for both employers,
but also the health plan itself, especially,
when considering the potential for earlier interventions and
the scalability of this model for for smaller
employers perhaps?
Yeah. That's a great question. And that is
really, you know,
the heart of this because,
you know, generally, the dollar saved now is
is in prevent a dollar spent, I should
say, in prevention now really does pay off.
We looked at a lot of data points
as we're launching this program to to exactly
the point, Jacob, that you made.
So preventive oral care really does play a
crucial role in lowering health care costs over
a person's lifetime.
Studies show that for each dollar that people
actually invest in
oral care prevention can save somewhere between $8
and $50
in later restorative and emergency treatments.
And,
even more importantly, because the real dollars, let's
be honest, are less so in the dental
space versus the broader medical, you know, world
where things like, your hospital stays, inpatient costs,
specialist costs,
are significantly more expensive.
There's a real cost savings opportunity there too
and health improvement opportunity.
If you look at the average medical cost
savings for people
who are consistently getting preventive dental maintenance,
the the average cost savings there over time
is actually just over 6%, which may sound
like a fairly modest number. When you look
at the dollars involved,
on medical care, you're talking about, you know,
huge dollars very, very, very quickly.
Yeah. No. That makes a lot of sense.
That it's the savings isn't necessarily coming from
the dental space. So I think the the
natural question there, Dave, is what is the
potential for scaling this type of flexible payment
model into other areas of health care, vision,
behavioral health services?
Ultimately, where do you kinda see the future
of this going?
Yeah. We we actually, that's the thing we
spent a lot of time about talking with
with patient, and some of our of our
large employer clients. And we we initially focused
on offering
the patient solution to our Cigna Dental employer
clients,
and we kind of piloted it within with
my within my team and our Cigna Dental
business. But we quickly recognized that employers who
were interested in this kind of program and
would buy into,
something like this would actually wanna offer this
across their health care benefits, not just for
dental. So across medical,
pharmacy, behavioral health, vision, etcetera.
While we started with Cigna dental clients in
a dental only option,
we've actually expanded this, and it's currently available,
to employer clients either for a dental only
option or
across all their benefits. And not only that,
but whether or not those other benefits, medical,
pharmacy, etcetera, are with Cigna
or not. And and I think the the
reason for that is exactly what you just
touched on, which is
while there are absolutely cost saving opportunities just
specifically within the dental care space,
the real health improvement opportunities
and cost savings actually accrue more to the
medical side if you could start with oral
health care. So, yeah, we're excited about broadening
this to more of our clients, including those
that don't even have, you know, Cigna Medical
or behavioral.
And we are looking at, the potential to
broaden this to even more of our clients,
specifically including those that are not currently Cigna
Dental clients. So I think there's a lot
of upside here. And and and to your
point, we we've already,
kind of taken that first step to expand
and scale this, beyond beyond dental.
Absolutely. So it sounds like big things to
come here.
Dave, before we go, what else are we
missing? You've got the attention of a lot
of other health plan leaders from all over
the country right now. What else do you
wanna share with them on this topic, or
is there any other final bits of advice
that you would wanna
share, while while we're on the call today?
I think one thing I would highlight is
that,
which we didn't really talk about is while
this has broad, potential, I think, the the
approach of helping people
use their benefits effectively and actually get the
care they need,
even if they have coverage, we should not
assume that they can afford to use it.
And the program like this does allow them
to actually afford to use the benefits that
they're paying for.
And and in particular,
you know, we've tried to figure out if
there are employer clients we had that had
employee demographics
who could particularly benefit from something like patient.
So for example, lower wage or hourly workers
who might struggle to pay these kinds for
these kinds of costs, employer clients who have
high concentrations,
of employees with social determinants of health challenges,
that type of thing. And
I should have actually mentioned this in terms
of some of the results of the program,
but we we were really, you know, hoping
that we were going to see more people
in communities that are facing even greater financial
barriers take advantage of the program, but we
weren't sure until we started this. Luckily, we
did actually see exactly that.
We're actually seeing,
higher utilization
amongst,
individuals who have, you know, higher SDOH
or SDI challenges than the general population. So
I think in addition to everything we talked
about, there's also a real opportunity to support
diverse
populations and kind of disproportionately
provide assistance to people who struggle even more
with with the cost of care.
Yeah. No. That's a great last call out
there, Dave, that so far this model is
really,
helping a lot more people who are living
in underserved communities. So I really appreciate you
you hooking that on there.
And and overall, thank wanna thank you for
taking the time to chat with us on
the podcast. We we really appreciate it. My
pleasure. Great to talk to you, Jacob. Thank
you. You as well. And to our listeners,
if you'd like to listen to more podcasts
from Becker's Healthcare, you can visit beckershospitalreview.com.