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Building Toward a Transformative Model of Health Care
The delivery of health care has become increasingly costly, complicated, and fragmented – creating inefficiencies and gaps in care that are deleterious to patients, communities, and health care systems within our key markets. In 2020, these were further exposed and enlarged by COVID-19.
Cigna’s goal is to redefine the future of health care to create a system that connects people to the best care and medications, in the best place, at the best time. We see each person as a whole person – so we treat the body and mind as one to help people live their healthiest lives. And because we aren’t confined to specific care delivery models, we have the flexibility to quickly and effectively meet stakeholder needs anytime, anywhere.
Our approach is straightforward: We leverage data, advanced analytics, and technology to improve health and to create more connectivity between the individual, their health care provider, and the health care system.
Our formula for change can be outlined in three dimensions:
- Affordability – All Americans should have access to high-quality, affordable health care. Cigna is committed to advancing policies that will improve access. We are also deeply committed to affordability – aligning health care delivery around the patient. We believe that in order to ensure affordability, we need to strengthen what works in America’s health care system – building on the employer-based health care system and public-private partnerships such as Medicare Advantage and health care exchanges in addition to working with health care providers who provide quality, cost-effective care. We remain committed to delivering sustainable medical and pharmacy costs for our customers. Affordability also drives us to encourage, support, and incentivize health – for individuals and health care providers. The integration of behavioral health care as part of whole person health is also an important tool to lower costs.
- Predictability – To us means guiding customers to high-performing care anywhere – at an office, in an urgent care center, in an emergency room or through virtual care – and ensuring our customers know we are here for them, 24/7, through on-demand support and resources. This includes supporting our customers and clients through the COVID-19 pandemic, including protecting them from surprise out-of-network bills through our Customer Protection Program. Predictability also means innovative programs and tools, such as the Patient Assurance Program℠ for diabetic insulin and Embarc Benefit Protection℠ for gene therapy. The Patient Assurance Program℠, launched in 2019, creates cost predictability for customers managing their diabetes. This program ensures that eligible customers with diabetes in participating plans pay no more than $25 for a 30-day supply of insulin.1 Also launched in 2019, Embarc Benefit Protection, brings together health services, medical management, and specialty pharmacy expertise to make breakthrough medicines more affordable and ensure access for those who need it. We built Embarc Benefit Protection to be flexible and grow over time as we anticipate the market for gene and cell therapies will only increase as the focus on niche diseases also increases. In 2020, more than 7 million customers enrolled and approximately 100,000 diabetic participating patients received financial relief totaling roughly $16 million. We expect total participating patient savings in 2021 to reach approximately $35 million. In addition to these programs, analytics-driven solutions are creating predictability for customers by allowing us to proactively identify and address risk.
- Simplicity – For Cigna means a more integrated and personalized health care experience; tools and resources that promote connectivity and engagement; and tailored networks of hospitals, pharmacies, and providers.
Cigna’s integration with Express Scripts and launching of Evernorth℠, a next-generation health service portfolio, has furthered our creation of a blueprint for personalized, whole person health care, enhancing our ability to put the customer at the center of all that we do. Together, our data-driven insights, combined with our clinical expertise, have enabled us to create uniquely tailored interventions to deliver the right amount of medicine to the right customer at the right time. Our differentiated solutions address both utilization and cost, positioning us to deliver health outcomes that our competitors cannot. Cigna also strategically focuses on offering customers choice, to make it easier for them to access the health services that they need.
Evernorth: Bringing People Together to Drive Progress
Evernorth is Cigna’s new brand for the company’s high-performing health services business and is built on four core capabilities that are critical drivers of value for clients, customers, and partners: pharmacy, care coordination, benefits management, and intelligence.
Our capacity to both understand emerging marketplace needs and create solutions for those needs spurred the creation of Evernorth. Through Evernorth we are bringing people and capabilities together to drive progress. Specifically, our connected solutions include the following:
- inMynd℠ – A personalized solution that helps patients and payers better recognize, treat, and support behavioral health conditions.
- Embarc Benefit Protection℠ – We bring together the expertise of the company’s health services, medical management, and specialty pharmacy businesses to make breakthrough, potentially life-changing medicines more affordable and ensures access for those who need it, while protecting clients from the shock of high-priced one-time treatments they might not anticipate.
- FamilyPath℠ – FamilyPath is a comprehensive fertility benefit solution that combines integrated medical benefit management, a network of high-quality physicians and labs, and a high-touch, proactive member-engagement model to provide holistic fertility care coordination across the health care continuum. With an increasing number of organizations adding fertility benefits, it is important to have a solution designed to nurture the future of growing families while avoiding unnecessary cost and stress.
- Healthy Ways To Work℠ – Companies likely won’t be back to “business as usual” anytime soon, if ever. Some impacts of COVID-19 on how we all work – and how patients access care – could be here to stay. Healthy Ways To Work provides companies with a diverse set of capabilities to move forward and keep people healthy long-term by addressing both the immediate needs and the evolving nature of the crisis.
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Cigna One Guide® is our advocacy infrastructure – the people, process, and technology that engages customers in a new way. Our integrated, multichannel experience combines intuitive digital tools and services with the expertise and empathy of our Personal Guides, powered by proprietary analytics. One Guide provides personalized reminders about preventive care, health coaching, and available financial incentives. It is powered by artificial intelligence (AI) analyzing data from medical claims, and it anticipates – and meets – customer needs. At present, Cigna One Guide® is our advocacy infrastructure – the people, process, and technology that engages customers in a new way. Our integrated, multi-channel experience combines intuitive digital tools and services with the expertise and empathy of our Personal Guides, powered by proprietary analytics. One Guide provides personalized reminders about preventive care, health coaching, and available financial incentives. It is powered by AI analyzing data from medical claims, and it anticipates – and meets – customer needs.
Serving as a Catalyst for Health Care Innovation
Innovation at Cigna happens in several ways, including organic innovation, acquisitions, partnerships, and Cigna Ventures, our strategic corporate venture capital fund and wholly owned indirect subsidiary. Cigna Ventures’ mission is simple: to be a catalyst for health care innovation and change that helps improve the health, well-being, and peace of mind of those we serve.
Cigna’s venture capital platform complements our existing commitment to organic innovation and research and development (R&D) – so we can bring more personalized, outcomes-focused solutions to market faster. Cigna Ventures accelerates our company’s commitment as a partner of choice in health care through its focus on addressing critical market needs for affordability, predictability, and simplicity.
In 2018, Cigna committed $250 million to Cigna Ventures to fund investments in promising startups and growth-stage companies that are making groundbreaking progress in three strategic areas:
- Digital health/experience
- Care delivery/enablement
Portfolio Company Highlights
By investing in and partnering closely with companies that are transforming health care, we work with them to deliver innovations to customers and clients. Each Cigna Ventures partner has a proven track record of delivering improved value and health outcomes. Through these deep partnerships, we collaborate, innovate, and solve for critical market challenges impacting our stakeholders. Then, we introduce novel solutions that address them head on. This type of partnership benefits our key stakeholders because it’s based on information sharing as well as the testing and learning of new tools, technologies, and innovations – all with the sole focus on customer, patient, and client needs.
Cigna Ventures Direct Investment Portfolio
|Digital health/Experience||Insights/Analytics||Care Delivery/Enablement|
1The Patient Assurance Program is available to customers in participating non-government funded pharmacy plans managed by Express Scripts, including Cigna and many other health plans with out-of-pocket costs for insulin greater than $25 (out-of-pocket costs for insulin include deductibles, copays, and coinsurance).