The Cigna Group will invest in making prior authorization faster and simpler in 2025, CEO David Cordani said.
On a Jan. 30 call with investors, Mr. Cordani said the shooting of UnitedHealthcare CEO Brian Thompson has "challenged us to even more intensely listen to the public narrative about our industry."
"At the Cigna Group, we are further accelerating improvements and innovations to increase transparency, expand support and drive even greater accountability," Mr. Cordani said.
The fatal shooting of Mr. Thompson brought on a wave of anger and criticism toward health insurers, often over delayed and denied care. UnitedHealth Group executives also signaled they will continue to streamline prior authorizations in response to the backlash.
Cigna is also moving to reduce out-of-pocket drug costs for some customers of its pharmacy benefit manager, Express Scripts. The company will implement policies designed to prevent members from paying the full list price for drugs, according to a Jan. 29 news release from Cigna.
Here are 10 things to know:
- Brian Evanko, the Cigna Group's CFO and the CEO of Cigna Healthcare, told investors the company expects to spend up to $150 million on initiatives to improve patient and member experience. The spending is split across the company's two divisions, Cigna Healthcare and Evernorth.
- Mr. Cordani said efforts to ease prior authorization and improve access to care navigation for members with complex health conditions will "incur additional costs" but are "critical actions for the benefits of customers and patients."
- Evernorth, Cigna's health services arm, will implement policies designed to prevent Express Scripts' customers in high-deductible plans from paying the full list price for medications. Most Express Scripts patients pay less than $100 per year for their medications, the company said in a Jan. 29 news release.
- Evernorth, Cigna's health services arm, which manages Express Scripts, will shift its standard offerings to prevent patients with high-deductible plans from paying the full list price for medications before they reach their deductible.
- Cigna said it will also implement better predictability in drug pricing for patients, especially those in high deductible plans, according to a Jan. 29 news release.
- Evernorth will also provide patients with a personalized summary detailing annual prescription drug costs, discounts negotiated by the PBM and the amount their insurer pays for drugs.
- The company will give plan sponsors an annual standardized report of costs and pharmacy claims beyond what it currently provides, Mr. Cordani told investors.
- The policies come as PBMs face intense scrutiny from lawmakers and regulators. In September, the Federal Trade Commission sued the nation's three largest PBMs — Optum Rx, CVS Caremark and Express Scripts — alleging the companies inflated insulin prices. The agency has issued two reports in the past year criticizing PBMs' influence over drug pricing.
- In September, Cigna sued the FTC, alleging a report issued by the commission was "unfair, biased, erroneous, and defamatory."
- Other PBMs have announced similar policies designed to benefit patients. In January, UnitedHealth Group CEO Andrew Witty said Optum Rx would pass 100% of negotiated rebates on to consumers by the end of 2028.
This story was first published Jan. 29 and updated with additional details Jan. 30.