Each CIGNA plan participant, including employees, retirees and dependents, can work with a CIGNA registered nurse, health educator and behavioral health specialist assigned to them, said Pam Lovell, director for clinical operations for CIGNA. These coaches provide one-on-one support over the phone whenever plan participants call. The participant will talk to the same coach each time, so they build a relationship.

These clinicians, who work only with city of Houston participants, promote health, help participants reduce risky behavior, and provide them with a single point of contact to manage their diseases, Lovell said. And it’s all free.

“The team helps the participant understand what they want out of life and what health and wellness goals they want to accomplish, and how to accomplish them,” she said. “The participants are paired with coaches whose experience matches their risks, needs and preferences.”

If you haven’t gotten a “hello” call from Your Health First or letter yet, you will. And CIGNA hopes you’ll answer the call to a healthier future.

“Everyone has some personal goal that we can help them with,” Lovell said.

How it works

CIGNA looks at data from the health assessment, diagnoses, prescription drugs and health claims to determine if participants could benefit from a CIGNA program. If so, the participant will receive an automated call. The participant can talk to a wellness advocate or call back later.

If a participant has a severe risk but doesn’t talk with the advocate, CIGNA may call again, Lovell said.

If plan participants have a gap in care – for example, a missed yearly exam – they may receive a call to check on health issues and remind them of the importance of the timely exams.

Participants who don’t receive an automated call can call 800-997-1406 to talk with an advocate.

The personal advocate provides information about programs and resources and asks basic questions to help the participant determine which program may help them. Then, the advocate connects him to the appropriate health coach. The coach talks to the participant about his needs, goals, desires and motivation. They talk about tools to achieve his goals.

For instance, for the hour-long first call dealing with weight issues, the wellness coach and participant will discuss daily life, portion sizes, snacking, exercise and more, Moreno said.

They’ll talk about specific, measurable, attainable, realistic and timely goals. After the initial call, the coach will mail a workbook, tape measure, food pyramid, portion plate and pedometer.

Then, the participant can have numerous shorter follow-up coaching sessions to discuss issues, concerns and successes, Moreno said. If the participant is talking to a health educator and an issue comes up that can best be solved by talking with a nurse, the nurse will be routed into the call.

After the coaching sessions are complete, the coach will call the participant 30, 90 and 180 days later to check in.

Meet your team

If you’re in good health with no apparent risk for a chronic condition, you’ll talk to one of three health educators, who are also dietitians.

You can also talk to a behavioral health manager, a licensed counselor who can help with stress and depression management and other psychosocial issues.

People with chronic conditions will talk to a nurse about how to manage their condition, and the nurse will help coordinate care among doctors, except for members of the KelseyCare plan; Kelsey-Seybold handles the case management for its members.

The nurse will call before and after hospital stays to check on the participant, answer any questions, and make suggestions.

But, Moreno and Lovell emphasize, it comes down to the plan participant. “In other roles, nurses are directive,” Lovell said. “In these sessions, they are really collaborative. Their purpose is to help you understand your goals and what you need to do to reach those goals.”

The plan participant has to pick up the phone and make the call, or at least press 2 to talk to a wellness coach.

Lovell and Moreno hope city employees take advantage of the coaches simply because they can, because they’re another avenue to better health and a better life.

“This is about helping you. And here’s what we can do together to help you reach your goals to better health,” Lovell said.

Offering these coaches is the responsible thing for CIGNA to do, Lovell said. It will help keep claims down, which will keep costs down for CIGNA, the city and plan participants.

“The only way we’re going to get costs down is to change people’s behavior so that their lifestyles are healthier,” Lovell said.

What is discussed with the wellness coach is confidential and not shared with the city, Lovell and Moreno said. It can’t be used against plan participants.