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Sep 15, 2023
New supplemental health benefit cushions the cost impact of musculoskeletal hospitalizations

Quick Take

  • Out-of-pocket costs for an MSK-related hospitalization can add to worker stress and anxiety.
  • A new supplemental health MSK rider can provide financial protection during a an MSK-related hospitalization.
  • Employers can support workforce well-being by offering the most comprehensive supplemental coverage in their benefit plans.

Musculoskeletal (MSK) conditions are a major impediment to workforce well-being, affecting 50% of U.S. employees. In addition to being the No. 1 driver of chronic condition health care spend, MSK conditions greatly impact quality of work and performance, resulting in over 360 million lost workdays and $297 billion in lost productivity each year.

Dr. David Mino, national medical director of orthopedic surgery and spinal disorders at Cigna Healthcare, says that a key factor of lost productivity can be the impact of MSK conditions on the workers’ mental health, and not just their physical health.

“Many people experience emotional and mental health challenges while coping with chronic bone and joint pain,” he said. “It is little surprise that many workers suffering from MSK conditions also face cooccurring behavioral health conditions as well.” In fact, one-fifth of Cigna Healthcare health plan members with an MSK condition were also diagnosed with anxiety, and over one-tenth also had a depression diagnosis.

These impacts on mental health typically lead to decreased productivity on the job, Dr. Mino said, adding that the problem can be compounded further when a worker needs hospital treatment for an MSK condition. “Much of the treatment costs for an employee’s MSK condition is covered by traditional medical coverage, at least for the outpatient care,” he explained. “When hospitalization comes into the picture, patient out-of-pocket costs can be quite significant.”

The average out-of-pocket costs for a hospital stay due to an MSK diagnosis is $1,835 per person, according to recent Cigna Healthcare claims data, which can be a substantial financial burden for many employees. Research shows that nearly half of U.S. adults are unable to pay an unexpected medical bill of $500 unless they borrow money. What’s more, nearly one-fifth of adults with health-care-related debt say they will never be able to repay it. “Financial wellness is a key part of an employee’s peace of mind,” Dr. Mino said. “So, in addition to the stressful work disruption from the hospitalization itself, the personal cost impact can continue to negatively affect mental well-being and job performance when the person goes back to work.”

A new supplemental health benefit offers financial peace of mind

Employers can now further support their workers' well-being by helping them prepare for the potential cost burden of an unexpected hospitalization for an MSK condition, thanks to a new MSK rider Cigna Healthcare offers with its Supplemental Health Critical Illness plans. These plans already help provide financial protection by offering a lump sum benefit to enrolled employees and their covered family members when they are diagnosed with a covered critical condition such as cancer, heart attack, or stroke. The new Critical Illness MSK rider offers similar protection in the event of an MSK-related hospitalization: a one-time payment up to $3,000 per calendar year. Employees can use the cash provided to cover their hospital costs as well as any other expenses they have, such as rent, transportation, childcare, utility bills, and groceries. This helps offer employees and their families greater peace of mind by helping to address financial security.

The new MSK benefit rider covers hospitalization for conditions such as cervicalgia (neck pain), intervertebral disc disorders, gout, lumbago (back pain), osteoarthritis, rheumatoid arthritis, scoliosis, spinal stenosis, spondyloarthropathy (spinal arthritis), and spondylopathy (vertebral spine disease). Employers can also offer their workforce the “MSK Plus” coverage level, which extends this benefit to include hospitalization for certain endocrine, heart/vascular and respiratory conditions, which also have high ongoing and recurring costs.

The new MSK/MSK Plus options are an industry first. “Employers have an opportunity to offer the most comprehensive supplemental coverage as part of their benefit plans, which can help them improve workplace productivity as well as attract and retain a talented workforce,” Dr. Mino said. He also noted that this coverage seamlessly aligns with Cigna Healthcare’s Pathwell Bone and Joint Program to offer a more comprehensive support solution to employees facing an MSK condition, while also reducing MSK care costs for employers.

This new addition to Cigna Healthcare Supplemental Health Solutions is one more way we deliver value to clients by addressing employee health challenges, increasing vitality, and decreasing total medical costs.

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