Cigna to Stop Using Ingenix Database
PHILADELPHIA, February 17, 2009 - Cigna announced today that it has partnered with New York Attorney General Andrew M. Cuomo to support the creation of an independent not-for-profit organization to administer a new database to determine reasonable and customary charges when people obtain covered care from doctors outside of Cigna's network. Cigna has agreed to contribute $10 million to the new not-for-profit, which will help individuals get transparent and accurate information about the costs of the care they receive. Cigna will also assist the new not-for-profit in this effort by providing its relevant billing and claims data.
"Cigna commends the Attorney General’s efforts to bring greater transparency to the pricing of health care services and we are pleased to partner in the creation of an independent not-for-profit organization to administer the new database," said Dan Nicolls, MD, northeast region medical director for Cigna. "As a leader in health care cost and quality transparency, we hope this new database will further enable people to make informed choices about their health care purchases."
In keeping with the rest of the industry, many of Cigna's health plans give individuals the option of choosing to receive care from a physician who is in the company's network or from a doctor that doesn’t have a contract and isn’t in the network. The Cigna network provides access to doctors who provide high-quality care and who have agreed to charge reasonable fees for their services. If an individual decides to receive care from an out-of-network doctor, then he or she is reimbursed based on a set fee, which previously was based on the Ingenix database, and the individual is responsible for the difference between the set fee and the billed charge.
A fully transparent system will provide consumers with additional information to assist with their physician selection process. For instance, it will reveal that for a 15-minute office visit in New York City - the most common service – health plans on average allow $74 to in-network doctors and as much as $160 using the Ingenix database to out-of-network doctors. Medicare pays $70 to in-network doctors and $77 to out-of-network doctors for the same office visit. However, on average, out-of-network physicians (who charge in excess of the amount previously set by the Ingenix database) charge consumers $214 – for the same service. More than 95 percent of office visits are made to in-network physicians today, and Cigna believes that increased transparency around physician pricing will further support efforts to drive lower cost, high quality care.
Helen Darling, president of the National Business Group on Health, said, “Employers support greater transparency and they support health plans continuing to determine what is reasonable and fair payment to out-of-network physicians.”
Cigna has been a leader in online health care information and decision support tools and is continually introducing innovative new online capabilities to help people improve their health, well being and security and better understand their health care. Cigna has been among the first to: provide radiology and outpatient surgery costs; estimate dental costs; and provide real-time side-by-side medication pricing from 57,000 pharmacies nationwide, each according to an individual’s specific health plan. Today’s agreement extends Cigna’s efforts to empower consumer choices and decisions.
Cigna (NYSE:CI), a global health service company, is dedicated to helping people improve their health, well-being and security. Cigna Corporation's operating subsidiaries provide an integrated suite of medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance, to approximately 47 million people throughout the United States and around the world. To learn more about Cigna, visit www.cigna.com.