The Cigna Group CEO Brian Evanko Talks Its 'Lead to One' Vision + Complex Care

Health company, the Cigna Group hosted its investor day at the end of September. There it dived into complex care leadership and introduced lead to one to drive durable growth. Joining me now with more on complex care and Cigna's position is its President and CEO Brian Evanko. Brian, welcome.

Thanks, Kristen.

Great to have you here at the Stock Exchange today.

The Cigna group has evolved significantly over the past decade. How has that evolution positioned the company for its next chapter of growth?

Well, one of the things we take great pride in at the Cigna Group is what we call portfolio shaping, which is making disciplined strategic choices as to which businesses we should be in and which ones we should not be in. So today we're fortunate to have three growth platforms. Cigna Healthcare, our health benefits arm, our pharmacy benefit services business, and our specialty and care platform. Each of them win in their own right with their own buyer groups, but also they mutually reinforce one another from the standpoint of data, clinical expertise and distribution excellence, that creates a leveraged impact across the Cigna Group. And each of those businesses are pointed at some of the biggest problems in healthcare. Most notably, the affordability of healthcare, which is an issue not just for patients, but also for employers, government agencies and health plans. Secondly, the fact that there are fragmented patient experiences too often when individuals go to navigate the healthcare system. And finally, the fact that more and more costs are concentrating in those with the most clinically complex healthcare needs. So the Cigna Group specifically pointed at addressing those problem statements.

How is your lead to one vision responsive to the forces reshaping healthcare today?

Our lead to one vision, the essence of it is personalization at scale. So we see the opportunity to serve each and every customer or patient. That's the one in lead to one. Each and every customer and patient with a distinctive, individually relevant healthcare experience. And it's possible now because the power of data, technology, clinical expertise, and individual context allows us to personalize in ways that we couldn't even just two, three, five years ago. So lead to one is our overall vision for what the future of healthcare needs to address those challenges of affordability, fragmented patient experiences, and more and more costs concentrating in the most clinically complex individuals.

You've identified complex care as an area where the Cigna Group is especially well-positioned to lead. What do you mean by complex care?

When we talk about complex care, we're talking about patients who take high cost specialty medications, or individuals who might see multiple providers. They might see a primary care physician and a specialist, or they might need clinical coordination across their medical benefits, their prescription drug benefits, and their behavioral health care. Many of them take multiple prescriptions. So think of an individual on a cancer journey, or someone with multiple sclerosis, or someone with Crohn's disease. Those are examples of the types of patients we're talking about who have the most clinically complex needs. And this is important because it's only 8% of the population that we're talking about, but it represents 55% of the healthcare spending. So we can have a disproportionate impact on overall affordability if we're able to serve the most clinically complex patients with distinction. That's part of our lead to one vision, but specifically pointed at that subset of patients who have the most clinically complex needs.

Dive more into why this is such an important opportunity for the company.

It's a great opportunity for the company because we have a leading position in specialty pharmacy capabilities in particular. So here you can think of high cost branded drugs to meet some of those clinically complex situations like oncology, like MS, like Crohn's disease. And at the end of the day, when we're able to serve those patients with distinction, we end up having a lifelong relationship with them. And so there's a mutually reinforcing benefit here to the patient and to the company. And this is an area in the healthcare system that's growing faster than the rest of US healthcare. I mentioned earlier 55% of all the spending is in the most clinically complex patients. We expect that number will grow in the future. In 10 years from now could be upwards of 75% of total healthcare costs. So it's really important that that population is served with distinction and we have the capabilities to do so.

How does that ability to manage complex care translate into differentiated value for employers?

So for employers, and we're fortunate to serve some 22,000 employers across the US. They each have diverse needs, right? Each and every one of those employers need something a little bit different. Some are very focused on the cost of their health benefits. Some are very focused on the patient experiences when they go to navigate the healthcare system. And they have different risk appetites as well. Many of them want budget certainty, so they want a very specific relationship with us. Others are willing to take more risk in their health benefits plan. And so we're able to serve the full gamut of needs that employers have. And the capabilities in complex care are particularly important because they allow us to build a risk management ecosystem where we can identify potentially high cost patients earlier and engage with them by having our nurses and our doctors intervene at the right moments with the right information. And the lead to one vision is personalizing each of those care journeys such that we can prevent people from going to the emergency room. We can prevent them from having an inpatient hospitalization by essentially engaging at the right time with the right information.

As investors consider the Cigna Group's long-term outlook, what gives you confidence that the company can deliver sustainable growth?

A number of things give us confidence in terms of the Cigna Group's long-term outlook. Um first and foremost, we have a long track record of success. The company's roots go back 234 years to 1792. Um we've proven the ability to strategically evolve, but also execute with financial discipline over that long period of time. Secondly, we're positioned in the areas in healthcare where costs are concentrating, those with the most complex healthcare needs. Our capabilities are specifically pointed at assisting those individuals in a distinctive way. Uh thirdly, the growth platforms we have, again, there are three of them. Cigna healthcare, our pharmacy benefit service business, and our specialty and care capabilities. Each of them win in their own right, but they also are mutually reinforcing from the standpoint of the data, clinical expertise and distribution excellence, that essentially give us a leveraged benefit when we have relationships across multiple parts of the company. And finally, we have a great team. So I'm fortunate our enterprise leadership team has on average over 14 years of experience with the Cigna Group, which gives us strong institutional knowledge, but also the benefit of outside-in orientation from some of the external hires that we bring into the organization. So taken all together, we think there's tremendous shareholder value creation opportunity.

Brian Evanko, President and CEO at the Cigna Group. Thank you so much for joining us here at the New York Stock Exchange.

Thank you, Kristen.