Cigna CEO: Healthcare Consumer Experience Key to Transformation

June 20, 2019 - NASHVILLE - Enhancing the healthcare consumer experience is the task currently in front of healthcare payers and providers, according to David M. Cordani, president and CEO of Cigna Corporation.

“Most importantly, how do we work to meet the consumer’s unmet needs,” he asked a ballroom full of attendees at the 2019 AHIP Institute and Expo. “Because ultimately, as service companies, as businesses, as delivery system organizations, fundamentally that is what you are trying to do.”

Like many other industry experts at this year’s AHIP Institute, the leader of the health service company with 95 million customers and more than 40,000 employees worldwide stressed the importance of developing a healthcare consumer experience strategy.

While Cordani pointed out that payers and providers are businesses and should, therefore, be consumer-oriented, the industry as a whole has been notoriously slow to adopt consumer-centric processes and capabilities.

In fact, one recent analysis performed by consulting firm Kaufman Hall stated that only about one-third of hospitals and health systems have at least a “thoughtful” approach to consumerism, while the remaining providers are letting their consumer experience strategies slip.

Payers and providers should be knowing their patients, helping them, and making their healthcare journey easier, and accomplishing this in a highly personalized manner, Cordani stressed.

“Individuals are saying, ‘Help me access the right care, the way I need it, when I need it, how I need it. Help me afford it. Then, eliminate surprises,” he said.

Cigna is working to address appropriate access to care, affordability, and negative surprises. For example, the payer recently partnered with Express Scripts to launch the Patient Assurance Program, which ensures diabetics in participating plans pay no more than $25 for a 30-day supply of insulin.

“That’s affordability that actually matters to the individual,” Cordani explained. “In a lot of cases, we think of being affordable on average as a society. But to Jane Doe or Bob Smith, in the month of January, who is trying to make a determination between paying the heating bill or significant out-of-pocket costs, that’s not affordable.”

“As an industry, we should redesign programs to provide that level of predictability and peace of mind.”

Cigna is also incorporating net promoter scores into management infrastructure to identify and prevent negative, surprising situations for consumers.

“It’s a guide to help understand what’s creating points of delight and what’s creating points of detraction,” he said. “Surprises are the number one detraction.”

But more still needs to be done to truly transform healthcare into a consumer-centric, high-value industry, Cordani stated.

Creating a transformative healthcare industry

The healthcare industry is currently in a transitional state. Since the Affordable Care Act, payers and providers have been starting to improve consumer engagement, align incentives with value, implement alternative payment models, like accountable care organizations (ACOs), and so on, the Cigna leader explained.

“We believe that model gives way to another so-called transformative model that evolves with a much more accelerated movement to deliver more value to the individual,” he said. “And in our view, that transformative model has several major points.”

The first point is taking a whole person orientation. The industry needs to break down the barrier separating comprehensive physical and behavioral health to truly be consumer-centric.

“The whole person orientation needs to be addressed in a much more aggressive way,” he said. “For example, today we know that an individual with a chronic disease is seven times more likely to suffer from depression. And we know, in the US, we’re approaching approximately 50 percent of Americans having at least one chronic condition.”

“Yet the clinical depression commonly goes untreated, or in cases where it is treated, it is treated inconsistently or incompletely. And when that transpires, the depression frequently gives way to more medical conditions.”

The transformative period will also focus on bringing patients and providers closer together in a manner that is actionable and valuable to both parties.

For example, Cordani reported that Cigna removed about a quarter of pharmaceutical opioids for all their medical and dental customers by working with practing physicians and dentists, one patient at a time.

“It’s the connectivity with the individual and the provider that’s creating actionable insights, one person at a time,” he said.

The third and final point is driving change through consistent, rapid innovation, like using wearables to connect with patients, placing social workers in the medical practice, and other innovative tools and strategies that re-engineer how providers work.

“It’s rapid stage innovation that’s required to be able to drive continuous change to benefit the individual with an orientation of the whole person and driving connectivity going forward,” he said.

Payers and providers are on their way to entering this transformative period, Cordani reassured attendees. He identified several of what he called “bright spots,” which included greater care coordination, especially for beneficiaries of Medicare Advantage plans, employer-sponsored health plan programs that remove all financial impediments for the chronically ill, and activation programs that identify high-risk pregnancies.

But a notable bright spot is the evolution of ACOs, Cordani stressed.

“Accountable care relationships deliver a lower cost, higher quality of care, are compliant with evidence-based care, provide a better consumer experience as measured by the net promoter score, and importantly, a better healthcare professional experience,” he said.

Outside of Cigna, the alternative care delivery and payment model has also been linked to care quality and savings, including Medicare’s largest ACO program, which currently manages over 550 organizations.

Cigna plans to learn from and build on internal and external bright spots to move to the transformative period. The payer even intends to deliver a medical costs growth that is no greater than the consumer price index by 2021.

The goal is ambitious, but Cigna believes it is what society is calling for.

“Society can’t afford the rate and pace of the trajectory today,” Cordani said. But the industry can help “by improving quality...and engaging people to keep them healthy.”