Health insurers don’t by law have to play a part in the fight against opioid addiction, though some have decided to do things on their own; Anthem, for instance, as Managed Care has noted.
Cigna’s also been doing its share, as well, using artificial intelligence (AI) to pinpoint beneficiaries who may be at risk for opioid overdose.
It’s not just about being a good citizen, though.
“If we’re doing work in the opioid space that’s unparalleled, we’ll be the preferred partner for the customer, client and the physician,” Mark Boxer, Cigna’s executive vice president and global chief information officer, tells the Wall Street Journal (WSJ).
Cigna hooks up 16 datasets to algorithms that look at patients’ pharmacy activity, behavioral health claims, and chronic disease history. The company went all-out wonk in this pilot effort, which ended in June 2018, hiring more than 1,000 data scientists, analytics experts, and software engineers. The health plan has been able to identify and better monitor about 1,130 people at risk for an overdose within the next month.
“Cigna’s proprietary algorithms are aided by the use of machine learning, a subfield of artificial intelligence that refers to the science of getting computers to act intelligently without being explicitly programed,” the WSJ reports.
More than 40% of the 42,250 opioid overdose deaths in the U.S. in 2016 (the last year data are available) involved a prescription opioid, according to CMS. The most common drugs involved were methadone, oxycodone and hydrocodone.
Boxer tells the WSJ: “It’s getting increasingly hard to detect the signals and patterns from all that data. Separating the signal from the noise in health care can create tremendous value.”
One of the tools developed by machine learning is One Guide, which Cigna uses to analyze data from numerous sources in order to identify beneficiaries who have not used financial incentives for free health coaching or checkups. These customers are sent reminders via mobile app.
Boxer tells the WSJ that “we want to be relevant to the consumer in a way that differentiates us.”