In 2025, Cigna partnered closely with Koda to test a member incentive program that embedded Koda’s digital ACP experience into its rewards offering. The results provide a strong signal for plans exploring how to scale ACP engagement without sacrificing quality.

Cigna had already been engaging members to complete their advance care plans prior to introducing incentives. But in early May 2025, ACP completion through Koda was included in a broader member rewards campaign, with a targeted outreach email sent in May.

The impact was immediate and measurable:

• By the end of April 2025, members had completed 1,330 ACP plans
• By the end of May, total completions reached 2,451

That’s 1,121 new completions in one month, an 84.3% increase.

Looking beyond the initial surge, the incentive also changed the ongoing pace of engagement for the remainder of 2025:

• Before the incentive program: ~88 ACP completions per month
• After the incentive program: ~145 completions per month
• A sustained ~65% increase in monthly completions

Incentives helped more members take action and raised awareness about how they could be more proactive in planning their care.

Incentives Aren’t Enough on Their Own

While the increase is compelling, the more important takeaway is why incentives worked in this case.

The incentive didn’t stand alone. It was layered onto an ACP experience that was already:

• Digital and easy to access
• Guided step-by-step in plain language
• Designed to reduce friction and confusion
• Structured so plans were actually completed—not abandoned midway

In other words, the incentive lowered the barrier to starting, but the experience itself made it possible to finish.

This distinction matters. Incentives can prompt clicks, but they don’t fix broken workflows. When ACP is confusing, time-consuming, or emotionally overwhelming, rewards alone rarely produce meaningful completion or quality.

Koda delivers a best-in-class patient experience by making care planning simple, guided, and accessible. Patients engage through short educational videos, plain-language prompts, and step-by-step support at their own pace—along with tools to help start meaningful conversations with family members. 

With language-accessible content and human advocates available when questions or complexity arise, the result is higher completion, deeper understanding, and plans patients actually trust.

What This Means for Health Plans

Cigna’s experience reinforces a pattern we see across MA plans:

• Incentives accelerate engagement
• Quality and ease of experience determines completion
• Sustained impact comes from pairing both together

For plans considering incentives as part of their ACP strategy, the lesson is clear: incentives work best when they’re paired with a simple, guided experience members actually want to complete—and one that produces usable, high-quality ACP data.

Used thoughtfully, incentives can help ACP reach scale faster. But the foundation still has to be strong.