Cigna Behavioral CMO: Virtual Care to Continue in ‘Large Numbers’ Post-Pandemic

When the COVID-19 pandemic hit the U.S., private and public payers rushed to cover telehealth, making it easier than ever for patients to receive behavioral health care.

As a result, more than 80% of behavioral health organizations used telehealth for the first time amid the COVID-19 emergency, according to a recent survey by the digital solutions provider Tridiuum. The vast majority of providers say they plan to continue offering virtual services post-pandemic — but their ability to do so largely depends on payers.  

While it’s still anyone’s guess what the future of tele-behavioral health coverage will look like, it appears that at least one insurance giant — Cigna (NYSE:CI) — is plotting a course for continued tele-behavioral health coverage post-pandemic. 


“Even before COVID, we saw the potential that telehealth has, and the COVID pandemic has just accelerated the transition,” Doug Nemecek, chief medical officer of behavioral health at Cigna, said. “Behavioral health is just built for a transition to telehealth. … We expect that we’ll continue to see large numbers of behavioral health services to be provided through a telehealth virtual platform as we understand where and how to best use that.”

Nemecek made those comments Monday during a webinar hosted by the Health Care Council of Chicago. The conversation focused on addressing complexities of care during the COVID-19 crisis.

Given the impact COVID-19 has had on the prevalence of mental health conditions and substance use disorders (SUDs) nationwide, behavioral health is an especially important component of treating those care complexities.


According to a recent study by the Kaiser Family Foundation, nearly half of all American say the coronavirus has had a negative effect on their mental health. In even more concrete terms, Cigna’s home delivery pharmacy Express Scripts saw a 34% increase in anti-anxiety prescriptions, a 19% increase in antidepressant prescriptions and a 15% increase in sleep medication prescriptions in the first month of the coronavirus.

As such, Bloomfield, Connecticut-based Cigna has been “really focused on making sure in this pandemic that people have access to the supports, providers and services that they need to help address and help support their mental and emotional wellness,” Nemecek said.

The organization has done that largely by leaning into telehealth. Today, about 40,000 providers in Cigna’s behavioral network are able to provide virtual care.

To further help with access amid the pandemic, the insurer has also eliminated cost-sharing for all behavioral health visits, both those delivered via telehealth and in person, and implemented a fast access network, which ensures customers get a virtual or in-person appointment within five days of seeking care.

On top of that, Cigna has added new digital providers to its national network, such as Talkspace, a text-based therapy platform the insurer brought on in May.

“We’ve already had over 5,000 Cigna customers sign up, register and start receiving care and support through the Talkspace platform,” Nemecek said. “Other digital platforms, as well, are being added as we move forward.”

Cigna also expanded its centers of excellence for behavioral health program, with the goal of helping members find the best providers for mental health or substance use conditions in their areas. For example, amid the COVID-19 emergency, the provider added a centers of excellence program specifically for members struggling with eating disorders.

Finally, Cigna rolled out a number of special resources for front-line workers amid the pandemic, from mindfulness programs to online resources and other tools.

“We’re actually the first national health plan that is in the process of developing a certified treatment network for providers that is specific to taking care of health care providers and first responders,” Nemecek said. “We’re really proud of that.”

Cigna’s efforts have succeeded in expanding behavioral health access to its members amid the pandemic. In fact, while the utilization of medical services dipped amid the coronavirus, the number of Cigna members accessing behavioral health services actually grew from pre-pandemic numbers.

“We expect it to actually continue to increase in the second half of the year,” Nemecek said. “And we expect that we may never go back to the baseline where things were before from a utilization and support perspective — but that we will eventually reach some new baseline as we get through the end of this pandemic.”

As is the case for most payers, it’s still unclear exactly what Cigna’s tele-behavioral health model will look like in the future. However, Cathy Dimou — a Midwest market medical executive at Cigna — said the organization continues to work on a viable, long-term plan, superior to its pre-pandemic strategy.

“Normally, we take years in medicine to make these changes, but we really ripped off the bandaid with COVID,” Dimou said during the webinar. “Now we have to learn how to make virtual care sustainable and effective moving forward. And so those are the things that we [are doing] as we try to make certain that we don’t lose this opportunity and we make the most out of these changes that have come from the silver lining of COVID.”

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