*A Condition-Specific Care Program

Cigna Pathwell Bone & Joint ^SM delivers a new standard of care for musculoskeletal (MSK) conditions. For members with spine, hip, knee, and shoulder pain, at every step in the MSK journey, we use state-of-the-art predictive models, personalized guidance, benefits, and navigation tools to empower customers to take charge of their health resulting in better clinical outcomes, increased productivity, and lower total medical costs.

Customers will have access to designated providers who meet quality and cost criteria, a clinical navigation experience supported by a Clinical Care Advocate that helps them make the right decisions about their care, and benefit design that rewards customers for optimal care choices.

Important information

Customers who have Cigna-administered plans that include this benefit option may continue to see their referring provider, such as an Orthopaedic or Neurosurgeon. However, the customer must see a designated Pathwell Bone & Joint Provider to utilize the enhanced benefits for surgery. The solution includes the following:

• Advanced predictive analytics models help detect people who are at risk of preventable musculoskeletal conditions so we can support them early, before those conditions become more painful and more expensive to treat. The care plans are designed to guide people to the care that will provide the most long-term value in improving their health and workplace productivity, including physical therapy, chiropractic treatment, and pain management support. In some cases, the plan may involve opioid prevention and management. Surgery is considered only when absolutely necessary.
• Cigna Pathwell Bone & Joint provides each customer with streamlined digital-first clinical navigation supported by a dedicated clinical care advocate, who is a licensed nurse or physical therapist. As the customer’s single point of contact, the care advocate works one-on-one with the employee to develop a personalized care plan, which includes screening for behavioral health issues and lifestyle management concerns, leveraging existing benefits to ensure people have the support they need. As part of this process, the care advocate helps them understand their treatment and provider options, guides them through the care plan, and offers care guidance and support every step of the way to keep them motivated and engaged.
• Customers also have access to a personalized digital experience where they can learn more about their specific condition and treatment. They can also complete assessments and other personalized activities that support their care plan. This results in a powerful approach to customer care that combines clinical expertise, coordinated support, and intuitive digital tools to empower employees to take charge of their health.
• When surgery is the optimal treatment path, Cigna offers a benefit providing low or zero* cost-share for surgery through discharge for engaged customers utilizing designated in network surgeons with historic track records of delivering quality, affordable MSK care.
  *Note that for non-HSA plans, the plan pays 100% of eligible expenses.
• For HSA plans, the plan will pay 100% after the deductible is met (due to Federal regulations). A travel benefit is available for customers traveling beyond 60 miles from home for surgery with a designated surgeon when program participation requirements are met.

How to identify Cigna Pathwell Bone & Joint Designated providers

Find providers who participate in the Cigna Pathwell Bone & Joint Designated Providers by outreaching to the Non-Clinical Care Advocate Team at ConditionSpecificSupport@Cigna.com.

For questions or support regarding the Program, call the Cigna Pathwell Bone & Joint Provider team at 855.678.0042.