Why Cigna's CEO is going all-in on the annual check-up - even if the science doesn't back it up
Cigna has begun a cross-country campaign to persuade people to do this. It includes a TV ad starring actors who play doctors on television shows.
Cordani says that when people go in for check-ups, they can build relationships with their doctors, and think about their lifestyles and how they affect their health.
"Be it childhood immunizations, be it mammographies, be it colonoscopies, etc., we've been able to prove that the early detection opportunity - when you connect the whole person to their physician or healthcare professional and support them the right way - could be powerful," Cordani said in an interview with Business Insider.
But studies on the effectiveness of annual check-ups shows they actually don't have a meaningful impact on long-term health. A 2012 Cochrane Review analysis of 14 randomized controlled trials found that "there was no effect on the risk of death, or on the risk of death due to cardiovascular diseases or cancer," the two leading causes of death in the US. That meant that there was no difference in the risk of death for these two areas between people who saw their doctors annually and those that didn't.
Cigna, though, says its own data shows that checkups can help control costs, by catching problems early and preventing them.
It makes sense that Cigna would focus on this, since it is the one picking up the tab in many cases.
Cigna's focus is on four benchmarks: blood pressure, blood sugar, cholesterol and body mass index.
The company recently shared the results of a three-year study on 200,000 of its own customers. Two or more chronic conditions - as determined by unhealthy levels of those four benchmarks - raised a person's out of pocket costs by $1,300 and total healthcare costs by $9,000, compared to those with one or none of those conditions.
So the idea behind the checkup is to try and spot risk factors early on, when lifestyle changes might be able to keep a chronic condition from taking hold.
There are other reasons proponents of checkups might encourage them. For example, annual check-ups might serve as a chance to get comfortable with your doctor. (Vox's Sarah Kliff wrote in September that this could be one reason to stop by regularly, in a piece that was otherwise about why checkups are a waste of time and money and lead to expensive tests that yield little benefit. Basically, she argues that Cigna's approach is wrong-headed.)
But Cordani says that the conversation between a doctor and patient does matter.
"All annual check-ups aren't created equal," Cordani said. Cigna encourages physicians to build relationships with patients so they can ask about the patient's lifestyle and overall wellbeing in addition to checking their blood sugar levels.
The screenings, to him, play a big part - if even because they're an excuse for that visit to take place, and might start a conversation.
"These four indicators are building blocks, they're foundational to enable the physician-patient conversation to evolve in a much more specific way," he said.