Access to Care

To ensure that individuals receive care quickly and efficiently, Cigna strives to meet defined goals for telephone responsiveness and for access to treatment appointments. Cigna’s Telephone goal is a live voice response in 30 seconds. Our 2013 annual Average Speed of Answer was 31 seconds. During the same period, 3.5% percent of callers abandoned their call, while waiting. Cigna's goal is that less than 5% of incoming calls will be abandoned. Cigna's Appointment Access goals are categorized to be consistent with the urgency of an individual’s perceived need when they seek care: 10 days for Routine; 48 hours for Urgent; and not longer than 6 hours for non-life-threatening Emergent needs. For individuals who seek Cigna's assistance to get appointments, Cigna measures how often a compliant appointment is available and offered. Cigna also measures timeliness of care appointments achieved for each appointment category, through an annual survey of satisfaction for all who access care. Routine and Urgent appointment access scores as measured by Cigna's information system met goal, while the annual Customer Satisfaction survey shows that individual satisfaction with access to Routine, Urgent, and Emergent appointments improved, but did not meet Cigna's goals. There continue to be few complaints regarding access.

Telephone Access

For 2013, annual average performance of 31 seconds did not meet the goal for an average 30 second speed of answer. The 5 % goal for abandoned calls was met, with an achieved 3.5% annual performance. Year over year, the Abandonment Rate decreased from 5.1% in 2012, while the Average Speed of Answer increased from 28 seconds. Staffing deficiencies negatively impacted performance in Quarter 4, 2012 and Quarters 1 and 2, 2013. Since that time, resolution of staffing issues has normalized telephone responsiveness to goal. The national Triage team for customer calls operates from a single physical location under centralized national management. To improve staff availability to customers, professional and facility calls are received by a separate staff team on a different phone line. Cigna continues to view telephonic access as a critical component of service and will continue to monitor performance carefully in 2014.

Appointment Access

Cigna believes timely appointment access is a critical aspect of service and is correlated directly to overall customer satisfaction. Cigna, therefore, has defined standards for access to Routine, Urgent, and Emergent care appointments that are consistent with customer perceived clinical need. In 2013, access for all categories of care appointment (Routine, Urgent, and Emergent) was measured using both survey responses from customer satisfaction and internal data from Cigna Information Systems. 2013 achieved performance of 100% met or exceeded all goals for Routine (80%), Urgent (90%), and Emergent (100%) appointment access, as derived from Cigna's Information System which reflects real time data entry for all cases. The Routine, Urgent, and Emergent ratings by consumers on annual satisfaction survey were rated lower, and did not meet established goals. The difference may reflect appointments missed or rescheduled by customers, or subjective considerations. The volume of customer complaints regarding appointment access remained low in 2013.

Customers may access routine care with contracted network professionals independently, or by using Cigna's online directory of contracted network professionals, without requirement for pre-authorization. Customers may also call Cigna for assistance in obtaining behavioral care appointments if that is their preference. Any customer who is experiencing an emergency may seek services without need to pre-authorize evaluation and stabilization services. In 2013, Cigna continued to respond to access calls using a centrally-managed, national call-answering team. To support customer appointment access, Cigna increased the size of its overall contracted professional treatment network by 5.87% in 2013, including an 11.71% increase in professionals who provide crisis stabilization services.