Cigna

The corporations on our annual list of the world's 500 largest companies combined to generate $41.7 trillion in revenue over the past year.

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Almost $20 trillion in revenue—and a record-breaking $1.87 trillion in profits. Introducing the 2025 Fortune 500, the definitive list of the biggest companies in America.

Fortune 500

The 300 companies on this year’s list brought in over $12.6 trillion in revenue for the latest 12 months, with the median revenue figure at $22 billion.

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The corporations on our annual list posted aggregate revenues of $41 trillion for the second year in a row.

Industries included in the sector are insurance and managed care, medical products and facilities, pharmacy services, and pharmaceutical companies.

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The corporations on our annual list of the world’s largest companies delivered a record $41 trillion in aggregate revenues.

G500-2023-Cigna

The insurer and health services company had a relatively slow year for revenue growth, but profits, at $6.7 billion, were up 24.3%. 
<ul> 
 	<li>Cigna has been working to expand “value-based” care models, which are designed to emphasize primary care and preventive medicine. To strengthen such care, Cigna entered into a strategic partnership with Walgreens-owned primary care provider VillageMD.</li> 
 	<li>Evernorth, Cigna’s service-provider arm, which also oversees the new VillageMD investment, has brought the company growth over recent years, and focuses on value-based care.</li> 
 	<li>Cigna Healthcare, the health-insurance benefits arm of the business, also expanded its margins and customer base.</li> 
</ul>

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The Fortune 500, in its 69th year in 2023, ranks the biggest U.S. companies by revenue.

F500 2023-Cigna Group

Just as it dominates our economy, Big Tech now dominates Fortune’s annual ranking of corporate reputation.

Aggregate sales hit $37.8 trillion last year—an increase of 19%, the highest annual growth rate in the list’s history.

G500 2022-30-Cigna

Global health services company Cigna had an up-and-down year. Despite bringing on an additional 8.4 million customers in its pharmacy division in 2021 and an 8.5% rise in sales, Cigna’s profits plummeted by 36% from 2020, to $5.37 billion. After years of litigation, an appeals court rejected Cigna’s attempt to claim a $1.85 billion breakup fee from Anthem in the wake of a merger agreement that fell apart a few years ago.

This year’s Fortune 500 marks the 68th running of the list.

F500 2022 Cigna

Global health services company Cigna had an up-and-down year. Despite bringing on an additional 8.4 million customers in its pharmacy division in 2021 and an 8.5% rise in sales, Cigna’s profits plummeted by 36% from 2020, to $5.37 billion. After years of litigation, an appeals court rejected Cigna’s attempt to claim a $1.85 billion breakup fee from Anthem in the wake of a merger agreement that fell apart a few years ago.

This year’s group delivered stellar revenue and profit growth, but it underperformed the broader stock market.

100 Fastest-Growing Companies

Total revenue for the world’s biggest companies fell 4.8% to $31.7 trillion this year—the first decline in half a decade.

G500-2021-028-Cigna

If there’s one element you need to home in on to understand health insurer Cigna’s 2020 success, Evernorth is a pretty good place to start. The company climbed more than 50 spots on the Fortune 500 after completing its merger with pharmacy benefits manager Express Scripts. That sent its revenues skyrocketing—and then the pandemic hit. How did Cigna manage to deal with that buzz saw? The Evernorth subsidiary, which encompasses Express Scripts, brought in $30.6 billion in the first quarter of 2021 and moved to expand its plan memberships in five more states and 67 new counties. It doesn’t hurt that Evernorth acquired the virtual care platform MDLive at the beginning of 2021—at a time when telehealth demand is soaring.

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-013-Cigna

Collectively, the ranked companies produced a three-year average shareholder return of 33%, vs. 19% for the S&P 500.

FGC 2021-Cigna

This year's Fortune Global 500 generated $33.3 trillion in revenues and $2.1 trillion in profits.

G500-2020-032-Cigna

Health insurer Cigna is enjoying a meteoric rise on the Global 500 this year, climbing 197 spots thanks to its merger with pharmacy benefits giant Express Scripts—yet another example of the trend toward "vertical integration" among large health care companies. The Express Scripts integration, completed in December 2018, fueled revenue growth that exceeded even Cigna’s own pre-merger expectations: Adjusted revenues for 2019 soared to $140 billion, compared with the $131 billion to $133 billion originally forecast.

This year's Fortune 500 marks the 66th running of the list.

F500-2020-013-Cigna

Health insurer Cigna ranked 65th on the Fortune 500 last year. This year? A meteoric rise to 13th, the result of its merger with pharmacy benefits giant Express Scripts—and another instance of the trend toward vertical integration among large health care companies. The Express Scripts integration, completed in December 2018, fueled revenue growth that exceeded even Cigna’s own pre-merger expectations: Adjusted revenues for 2019 soared to $140 billion, compared with the $131 to $133 billion originally forecast.

Collectively, the ranked companies produced a three-year average shareholder return of 19%, vs. 11% for the S&P 500.

Fastest-Growing-Companies-2020-59-Cigna

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This year's Fortune 500 marks the 64th running of the list.

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This year's Fortune 500 marks the 62nd running of the list.

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This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Global business is back. After limping through a worldwide financial crisis and economic slowdown, the 500 largest companies ranked by revenues shattered all sorts of performance records in 2013: They racked up combined revenues of $31.1 trillion, up 2.5% from 2012, and profits soared 27% to nearly $2 trillion. China’s 95 companies (up from 89 last year) posted $5.8 trillion in revenues. The U.S. has four fewer companies on the list than last year but remains (for now) the country leader, with 128 corporations on the list—including No. 1 Wal-Mart Stores—reporting $8.6 trillion in revenues. 

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

Fastest-growing Companies

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With roots dating back to 1792, the Cigna Group is an insurance and related services company serving millions of clients in the United States. Its Evernorth Health Services branch offers pharmacy benefits, home delivery, distribution, management solutions for plans, and health care providers. Meanwhile, the company’s Cigna Healthcare segment provides medical, behavioral health, dental, and other products to customers. In 2023, the business underwent a rebrand; Cigna Corp. changed its name to the Cigna Group, and its two segments became the primary business units.

Q2 2025

Q1 2025

Q4 2024

Cigna (CI): Company Profile, Stock Price, News, Rankings

legacy

cigna

With roots dating back to 1792, the Cigna Group is an insurance and related services company serving millions of clients in the United States. Its Evernorth Health Services branch offers pharmacy benefits, home delivery, distribution, management solutions for plans, and health care providers. Meanwhile, the company’s Cigna Healthcare segment provides medical, behavioral health, dental, and other products to customers. In 2023, the business underwent a rebrand; Cigna Corp. changed its name to the Cigna Group, and its two segments became the primary business units.

Cigna (CI): Company Profile, Stock Price, News, Rankings | Fortune

Bloomberg

John Tozzi

Cigna plans to limit out-of-pocket drug costs for U.S. patients

/well/2025/01/30/cigna-plans-to-limit-out-of-pocket-drug-costs-for-u-s-patients/

Erika Fry

Trump has promised to ‘knock out’ pharmacy benefit managers. How the drug middlemen became a $557 billion industry that its customers love to hate

/2025/01/21/pharmacy-benefit-managers-trump-cvs-cigna-unitedhealth/

Christiaan Hetzner

UnitedHealth, employer of slain exec Brian Thompson, found to have overcharged some cancer patients for drugs by over 1,000%

/2025/01/15/ftc-pbms-unitedhealth-brian-thompson-cvs-caremark-cigna-pharmacy-benefit-managers/

Ani Freedman

Former Cigna insurance executive says he quit after witnessing an industry that ‘puts profits over patients’

/well/article/cigna-opinion-health-insurance-profits-over-patients/

Sasha Rogelberg

Trump criticizes ‘rich as hell’ pharmacy benefit managers

/2024/12/17/donald-trump-drug-prices-healthcare-pharmacy-benefit-managers-press-conference/

https://fortune.com/2025/01/15/ftc-pbms-unitedhealth-brian-thompson-cvs-caremark-cigna-pharmacy-benefit-managers/?itm_source=parsely-api

Leah Nylen

FTC Sues CVS, Cigna, UnitedHealth over insulin prices

https://fortune.com/2024/09/20/ftc-sues-cvs-cigna-unitedhealth-insulin-prices/?itm_source=parsely-api

Former Cigna insurance executive says he quit after witnessing an industry that 'puts profits over patients'

https://fortune.com/well/article/cigna-opinion-health-insurance-profits-over-patients/?itm_source=parsely-api

Cathy Friedman, Executive Venture Partner, GV (Google Ventures)  Alyssa Jaffee, Partner, 7wireVentures  Anarghya Vardhana, General Partner, Maveron  Moderator: Andrew Nusca, Editorial Director, Fortune

Brainstorm Health 2024: Building Resilient Healthcare Companies

Conferences

Cathy Friedman, Executive Venture Partner, GV (Google Ventures)  Alyssa Jaffee, Partner, 7wireVentures  Anarghya Vardhana, General Partner, Maveron, Andrew Nusca, Editorial Director, Fortune

Hey, everybody. How are we doing? All right, we've got a great, a great session in store here. Um I want to start off by reading something that I was reading in a report uh from last year, so much has changed since last year, but it was a report last year about kind of the market conditions. It was, it's hard not to have a glass half empty view of the health tech market. Uh The reasons were that the public market markets were underwhelming. Uh that venture capital funding uh had been down since about 2021. Um It is however way up from a decade ago, I want to just say that um now we have lots of macroeconomic anxiety, soft landing versus hard interest rate cuts. A few, many, nobody knows what's going on. So I want to ask, are you feeling optimistic or are you feeling cautious? I am feeling optimistic. Uh And the reason I'm feeling optimistic is that there are a ton of great technologies and companies out there that need to be financed because they're meeting unmet needs for patients. Um And at our fund, we have a really long term view and I think if you have a long term view, these needs need to be met. There's money to be made and patience to be served here. So I am optimistic. I'm so sad to hear that people are feeling that the glass is half empty because while the heyday of the pandemic is over, what came out of Pandora's box was the consumer empowerment that we've all been craving in health care. So we're all looking to become better stewards of our health, right? Patients are people that have things done to them and consumers are active stewards of their health. More companies are getting funded today. The bar to start a company is lower. And so we're seeing innovation come in health care that we've never seen before. So while the funding markets may tell one story, the actual um capabilities of these businesses, the commercial traction they're getting from health plans, from health systems, from Pharma orgs Employers is beyond. I think what any of us thought could happen five years ago and please, I'll, I'll start with the hard part which I think if you're an entrepreneur right now, it can feel like fundraising is really, really hard, it can feel like the bar is higher than ever, which it is, it can feel like there's a lot of pressure from your board to hit certain unit. Economics hit certain goals. So the glass can feel kind of hot half empty as an entrepreneur. But I think the positive side of it is that now is the time to build an incredible company, the resilience, the grittiness, the forced constraints are allowing for companies to discover new business models, innovative ways of reaching customers in non expensive previously, Facebook and Google and also creating environments where companies and payers and providers who are purchasing the products are also demanding really, really high quality. So I think the clinical outcomes that will come out of this batch of companies is going to be better than ever before. Let me stay with you for a second. So you can invest in lots of different kinds of companies. Health as a category has different considerations. Share your perspective. What is great about a health uh uh uh company from an investment standpoint. What is a difficulty, a challenge? Yeah. So for context, I'm a consumer investor. So I invest in companies who think of the end patient as the consumer. So a lot of the business models are B to B to C, some are B to C and in health care. Unlike many other companies, there's so many considerations including ethical clinical clinical ones. Are you doing? What's right for the patient at end of the day? Are you driving better results? I think in the heyday of a lot of funding, we saw companies that were trying to deliver growth at all costs. That wasn't always the best thing for the patient. And I think we could all name a number of companies that were driving for that growth without always having the necessary guard rails around the company to protect the patient at the end of the day. Yeah, we um so our thesis is called the informed Connected health consumer. So how to all of us here in this room today? How do we get access to information, connecting into the system? The system connects back to us to improve our own health outcomes. But the thing is health care companies are not consumer companies and there became a very blurred line early on about in the pandemic of what those companies were and how companies were marketed or where the bulk of the dollars lie in health care, the bulk of the dollar dollars still lie with the incumbents and a lot of companies believe that if you build it, they will come and in health care, they will not come. That's and so creating business for they might come and stay for five minutes or they'll do a pilot and and not pay nothing, ask you to actually pay for that pilot. So I think ultimately, um what wasn't working? What doesn't work is people that don't have that understanding, people that don't have founder market fit, right? We talk a lot about product market fit. But why are you your team the right people to build this to do this? There's way easier ways to make money than to do this in health care. You've got to be here for something else. And that's what's most important, you know, you said founder Market Fit, is that right? So, so I was, I was, that was gonna be my next question, which is in this moment. Yes, thank you. I appreciate it. Well, no, in this moment, it's clearly a kind of a moment of reckoning. So what's working and what's not, are founders sufficiently resilient is capital, sufficiently patient, you know, are are the cost structures sustainable. This market environment is really tough to fundraise the bar is higher. What investors are looking for is different than what investors used to look for in the past and it's causing friction and frustration. But I think it also creates resilience in companies. I have not heard so many conversations about profitability in all my years of being a venture capitalist than I have in the last 18 to 24 months that we are actually building the right kind of companies, the appropriate level companies. And I think an argue says as well of clinical outcomes, like we are in this business to actually drive value in health care, to improve outcomes and to reduce costs. And that's not a buzzword on a slide, although we see it often on those slides, that is really the mission and the goal of what we're trying to do and many people miss that. So if you're building a company that actually shows how you can do that often, those companies will become the most successful. Yeah. And you have to have a clinical out comes, but you also have to have financial outcomes. So the best companies create dashboards that they say they set up uh goals that they want to reach and they, if they reach them great, if they exceed them even better. But if they don't reach them, they rejigger themselves and figure out how they can reach them because not setting goals. And just assuming some great story is going to take place because you have some great patient, something to deliver doesn't work in this market at all. I think that we're seeing uh a batch of founder who are incredibly mission and purpose oriented and financially oriented and want to build a business versus perhaps in the previous set of companies, there was a lot of mission, a lot of purpose and there was a hesitancy to even say, hey, we're building a business that can actually sustain itself with revenue and it feels like the two are finally coming together, maybe, maybe also the naivete around. Um I, I built this thing in tech or I built this thing in consumer. But gosh, being a health consumer is so hard and so frustrating and creates so much friction. I gotta go do that thing now. And it's an amazing passion and mission. But welcome to this world that all of us know is extremely complex and convoluted. And so if you aren't able to understand how to unlock it, many companies have found themselves really stuck in that process. Yeah. And I think you need to decide if you're gonna play inside the current system, meaning the payers and the providers, the employers, how it is right now, or if you're gonna do something completely different and play outside and we've done some investing on outside as well, which is also interesting. So folks, I'm gonna come to the audience in a few minutes with questions. So think about it. All right, I, I wanted to ask you. So where are we seeing in? What subcategories are we seeing success versus not that BioPharma comes to mind. Uh uh V BC comes to mind where in your particular portfolios, where are we seeing good and not so good? We tend to be vertical investors. So we really focus on companies that solve problems. Um We're less of a horizontal investor. Technology is great. A I is incredibly transformative, but it is not a one stop shop. And so where we focus on is how can A I be an application or component for care delivery? Um But it's not the thing. And so what is the thing that drives value? All of us are actually on a board of an amazing women's health company called Caraway that focuses on Gen Z women. So how do we help young women gain independence and agency in their health care? Journey. We're seeing a lot of these types of solutions start to really materialize because of their focus on the communities that they serve. I have a slightly different angle um which is a lot of the companies I'm seeing now have a different focus on the actual clinician than I've seen previously. I think that pre pandemic, a lot of clinicians, which I think a lot of you here in the audience are clinical practicing folks. Um We're almost seen as just a part of the business you use them, you move on, you get new ones, whatever. And for the first time, I'm seeing a focus on hiring great clinicians, retaining them, keeping them happy, developing them. And actually thinking of your clinicians as your big best and biggest asset, which is a big shift. I think in the start up world where that can sometimes feel slower and more cumbersome than let's just grow users by any means. Yeah, I think also really focusing on access because there are a lot of um areas within medical care where there just isn't uh a big enough supply. And the examples I can think of in our portfolio in menopause. We have midi, we have ULA, we have a Lara where you just don't have doctors that cover those specialties. So by providing that on in a telehealth way with the ability to go somewhere else for four wall treatment, you can make access so much better. So you don't have as many care deserts around the US. You know, I was actually that, that, that leads into, uh another question I was gonna ask is, you know, COVID and the pandemic just exposed a lot of gaps in the system and then there was a big rush. So, in your opinions, do you feel that those gaps persist? You know, are we starting to solve for any of them? You know, I think the gaps still persist, but the one that's been the most heartening for me is the focus on behavioral health. I think the pandemic showed America and, and the larger world, how lonely people are, how much connection they need and how important mental health is equally, if not more important than our physical health. And that acceleration, you know, we see tons of companies and behavioral health where investors and things like two chairs and bend and really being able to see companies focused on folks with mental well being I think is heartening and just continuing. I would, I would add to her comment, which is the physical and the mental are very connected. And in our prior prior to COVID world, it was sort of you had a mental health problem and you had a physical problem. And I think through COVID, it's become much more of common knowledge that those are very related. So you can't just have a mental health solution, you can't just have a physical health solution. They have to be integrated. The thing is Andrew. We are um I think we, we're at this time today where we're going to spend our entire lifetime and multiple lifetimes over trying to solve these problems in health care. And that's scary, but also um enticing of how big this thing can be. And we talk about access to care and the Medicaid population and companies, the number of who are here today Summer House, who does uh Tebas pediatric care, a company called Ground Game that does uh works with CB OS and a number of kind of scoh opportunities to really close gaps in care. There's so we can name a million more companies that are starting on this journey and even just getting initial penetration, we heard from Sarah London and the CEO of Centene. There's just so much that we have to do. Um And I think that should hopefully be an encouraging message to those in the fans today who are actually working to do this on the front lines because we are making progress. It just, it does take time and a brief follow up before we go to the audience. Um So many lifetimes, you know, investing does require a return. Have you heard this longevity thing? We're gonna live for many lifetimes. Keep investing. I see. OK. OK. Got it. Got it. All right. Let's go to the audience. They will live on forever. All right, let's, let's right over here. We'll wait for the mic for and please uh introduce yourself. Just name and, and organization, please. Hi there. I'm uh Doctor Natalie Davis from prevent Scripts. Alyssa, I can remember on a start up health call. Probably this was pre pandemic. I think you talking about series A metrics. Um Could you give us an update on series A metrics for 2024 and how that goal post may have tweaked on the Yeah, on the record, I don't actually think my answer personally has changed much. My answer is again, um We invest mostly B to B to C 50% of our capital comes from strategic organizations, health plans, health systems, pharma, employers. And so what I look for is if you know, Cigna is an amazing partner to us, for example. And if Cigna says, wow, your business is so amazing. I wanna do this. I wanna roll you out to all my national accounts. Are you gonna thrive or are you gonna be crushed? That is how we look, get a series A it's uh we don't have a definitive metric around revenue. I'm sure that, you know, my, my amazing panelists can give some more guidance, but at the end of the day, the core of what we think about is is your business in a place where we can take you to these large incumbents and you are able to carry whatever comes of that. Hopefully very, very large and long lasting contracts. Yeah, I would just add on to that. We don't have any specific tailored revenue tax, whatever, but we're very focused on the number one thing, which is the team, the number two thing, which is the product market fit and the number three thing, which is the ability to scale and that usually involves having some tech that's very good and deep. Um, so those things have not changed in this market at all. Well said, all right, let's find one more another, another audience question. Forgive me. It's very bright. Yes, way back here. Hello everyone. My name is Elena, the co founder and CEO of generation lab and we actually work in longevity. So that word is becoming bigger and bigger in the space right now. What we are doing is starting out from 19 different organ health and build a personalized plan from lifestyle, nutrition, medicines and also workout. So I want to hear a perspective of health care because it's becoming a new world from sick care that we used to be. How do you guys think about the new healthcare world is changing? Especially longevity is becoming a real trend right now. So, um I believe that the most important thing in health care is early detection right now before I joined Google Ventures, I was the chair of Grail. And to me, we can detect things early and that was cancer. But there are many other things and some people earlier today were talking about Children and detecting things early. So you have to be able to detect them early and that requires diagnostics and other things there. And then once you detect them early, you have to have personal medicine to deal with them. I'm less concerned with living to be 100 and 50 than I am living to be some age where I can be active and healthy and whether that's 80 or 90 or 65 doesn't really matter. Um But I don't want to be into the business of longevity investing just for the sake of living longer. I I think that a lot of the longevity conversations, content products are really tailored to certain like niches of society. And as a consumer investor, I think a lot about how does this get mainstream, how do regular people in the world use this access this and that feels like a lot of the missing gap. Of course, stuff has to launch first and they are early adopters and such. But, you know, my vision is with the power of A I, there is a possibility where people can know what is exactly the personalized tailored thing for them because right now the question is like, what test do I use? What protocols do I follow? Should I listen to this podcast or that one? And the more that can be personalized and accessible, the better also payers have to pay for it. So, you know, I think you you even in V BC and the, the journey to value based care is much more complex and not as straightforward as we thought. And we longevity fits. I'd say there's probably still a, you know, a knock on the fee for service door of how you can think about the entry way to build that relationship with the health plan in order to get to a real bundle or a real risk based contract, given the value of longevity. All right. Well, um, 2025 then is it gonna be the year of Pretenders or the year of contenders contenders? Absolutely. I think a lot of companies that are building right now are gonna be of a strength and girth and revenues w um, that it's gonna be a great market and you, you know, they're 30 companies right now that could break out to be phenomenal companies in 2025. 1 2nd. I'm gonna say contenders because great companies get funded. All right. All right. Ok. And Contenders. Ok. But please, that, that, that's our time. Give them a round of applause. Thank you so much. Yeah, that's correct.

David Cordani, Chairman and CEO, Cigna 
Interviewer: Arianna Huffington, Thrive


Brainstorm Health 2022 - Connected Health For All: Investigating In Access And Improved Outcomes

Investigating In Access And Improved Outcomes


Brainstorm Health 2022 - Connected Health For All: Investigating In Access And Improved Outcomes


Thank you so much Beth David, thank you so much for joining us. We've had such a fascinating conversation in the green room. I'll try and capture it all here. So, first of all, cigna has been at the forefront of incorporating mental health into health long before the mental health crisis was at the forefront of every conversation. So, tell us about that. We'll start with an example first. Hello everyone. It's actually nice to be physically present with individuals and not see you all on a video screen. I think that's a big part of our health opportunity. You are very good, very good, very good. Um but but quite some time ago, north of 15 years ago, our data told us that the um combination of mental health and physical health were connected and I'll just use an example. We were able to determine that if someone has a heart attack and obviously survives that heart attack, the probability of them being clinically depressed post the heart attack is quite high and most likely that the individual is not going to get diagnosed for clinical depression if the clinical depression is diagnosed and treated, the probability of a second heart attack is very low. So what we did is we integrated um word back then, we integrated behavior health professionals with our coronary chronic care management teams to work one patient at a time and one physician at the time that was an example early on before we were talking about resilience, loneliness or dealing with obviously the mental health challenges from the pandemic. So we've been at this for a long time, but it's data driven, it's one patient at a time or one individual at a time and it's coordinated with their medical professional. So as you're looking at a head at all these healthcare transformation happening right now, what do you think are the most important trends? So there's obviously a lot um that's transpiring and most for the good. Um in terms of driving change, we boil it down in terms of three major forces of change that we think are indisputable that we're living with now and will for quite some time. And they are pharmacological innovation. We think the next decade will be defined by chemical innovation in a positive way. Whether we know them as especially pharmaceuticals, whether we know them as new oncology drugs, whether we know it is biosimilars, the ability to be curative and life changing off of pharmaceuticals is quite impressive. Second is what we just started talking about globally. There's now the acceptance of the mind body connection. Um so people talk about his whole person health, but how do you convert that to targeted programs around mind and body. And then third is we call it alternative sites of care harnessing technology and data to bring care to the individual in a real time, highly personalized coordinated way as opposed to requiring an individual to go to care in a more fragmented, sometimes less personalized way. So those are the three large forces that we see and we're highly investing in. And in terms of the third, it's probably one of the reasons you bought empty live and the emphasis on virtual care which of course is being dramatically accelerated because of the pandemic, Where do you see that trend going? Absolutely. So we were partnered with MD Life for quite some time through our signal ventures, we concluded it was best um to fulfill that partnership and bring it as part of the corporation to provide us a platform and as an illustration, that platform that continues to grow pretty significantly is far moved from triage events to coordinated primary behavioral care programs. Um secondly, we've seen tremendous growth in utilization Third, we've taken behavior health modules off of the MD live platform um designed in a separate reoccurrence down to Children age level of 10 and above for behavior health programs that could be personalized to an individual. And then lastly as an illustration, we recently announced um taking the MD Life Underpinning of a platform and our oncology solutions and using data to identify a patient and an oncologist, a diagnosis and then marrying them up with a center of excellence somewhere in the country without the patient having to go physically to the Center of excellence for treatment coordination from that standpoint allowing the patient in most cases to stay home with their loved ones etcetera. So we see tremendous leverage of virtual care but not triage virtual care building it into the ecosystem. And lastly Ariana importantly not disinter mediating the physician extending the physician right This opportunity is to extend the physician as an extension of the team into someone's daily life. So you mentioned 10 year olds and cigna has just released a very important research on the mental health crisis among teenagers that has been in the news so much in the last week, tell us about the findings. Um So but by way of backdrop um some years ago, within the last five years or so we did a body of research collaborating with academic research organizations around um loneliness. And we learned that um the youth in America are of the most lonely age groups. We did the body research around resilience um leading into the pandemic. And we saw that while resilience taps down for individuals as they entered their teens, the pandemic was pushing it down yet even further for teens. And the most recent research um Ariana that you're making reference to um reinforces what we all know, see feel of the impact on mental health on our youth and our pre teens and teens a startling data point and then an end um Society is seeing a 50% increase in um female teenagers presenting in the emergency room for attempted suicide during the pandemic. So current state over 2,019 51% increase of young women attempting suicide. The and part of the research we learned though is that when you have a mental health need, behavior, health need amongst a child, there's a high correlation to an adult and their productivity. Their present e is um and the retention at work. So we see a 15-20% reduction based on the research for individuals at work if they're dealing with the mental health challenge with a loved one, a child at home and a higher probability of that individual either needing more flexibility, needing more support or leaving the workforce. And we know today in America there's a challenge with getting the workforce fully staffed, let alone that so startling statistics, but the data is a guide to action. So then you have to bring products, programs and services closer to their families through employers and closer to youth, which is one of the examples I made reference to bringing more programs down to age 10. Absolutely. In fact, we've been talking a lot during the conference about how employers are now also running a healthcare business. And what you said, we're seeing it. For example, we're working with fighter at thrive and we're seeing how the impact of um what's happening in the families in the lives of the Children is dramatically impacting the employees. The two things cannot be disconnected 100%. And we we view an employer, so whether it's in the United States or outside the United States, the basic philosophy we take is that an employer is a micro community. So an employer has a bunch of tools, has a culture, has a communication ecosystem, has peer support, has peer pressure, has the ability to use incentives, disincentives, reach assets, etcetera. And what the pandemic has also told us is that we all want healthy thriving communities. It's a fundamental need. We all have the best way to have a healthy, thriving community is to have healthy, thriving employers within the community, giving back, making a difference, et cetera. You can have a healthy thriving employer without healthy, productive, present, highly engaged individuals. So yes, and then it's one employer at a time. How do you design the solution suite that works for Fizer where they are in their change curve or works for fill in the blank your next employer. That's what we love to do. We love to customize the solutions one employer at a time, pull from the shelf, um, coordinate innovate. But it's one employer at a time because the employers are micro community and you see some really powerful outcomes and now with the C suite level, more c suite leaders are seeing it as part of their job. It's no longer somebody else's job as a procurement event. It's actually part of the strategy of how do I have a human capital strategy with thriving vibrant coworkers and therefore reaching into their families because finally we've seen how connected these are two business metrics, retention, attrition productivity, but tell us more about micro communities, you've written a whole book on that and it's such an important concept, Tell us more. So, um I'll try to be brief because I don't want to bore the audience and I could probably talk to you for an hour, but um I had the good fortune of co authoring a book with the founder of Achilles International. Achilles International was founded in the 70s to help people with disabilities always shapes and forms physical and otherwise. Um set goals be supported and then pursue those goals, typically physical in nature, so running or otherwise. And I've had the good fortune of being a volunteer with Achilles International for north of a decade guiding um assisting wounded veterans typically um single and double amputees through half and full marathons. And through that back to storytelling, we came up with the phraseology of a micro community because we all think that sometimes you need this large ecosystem to provide support or drive change. And in some cases the micro community is two or three people, it's the person with the goal and one or two people in support. And then if you have clarity, we put a recipe in the book, I like to cook. So a basic recipe in the book of goal setting, a strategy for pursuing the goal, a plan, recruit some support execution adjustment, which sounds like everything else we do in our lives, whether you're running a business or otherwise that micro community Could achieve things that people didn't think was possible. I sell them thoughts that you could take a double amputee, um 10 months after losing both limbs in Afghanistan, and 11 months later complete a half marathon or full marathon in that case. And what you see, lastly, Ariana off that, which is really powerful, it touches the mental health and physical health. Is those individuals take those successes to say, what else can I achieve, right? And they take that recipe to achieve other outcomes, other life outcomes, and they have more, full, more complete, healthier, um dynamic life. So, we chronicle that in the book and we do it through storytelling vignettes about individuals and their life experiences and how the micro community approach changes their lives. I love that. So, David, I want to end on a personal note, you have an incredibly demanding job, Um you've been an amazing leader, you could be working 24/7, your day never ends. So how do you actually take steps yourself um to take care of yourself, to protect your own levels of energy, you know, and I appreciate that. So, at first, I think we're all a perpetual working product process. So, I don't think anybody has the answer, I don't have the perfect answer, but, but one is being deliberate and mindful on it. So I work out every morning, uh no matter where I am pre pandemic in the world, um, I work out every morning in some way, shape or form and while it's physical health, I would submit, its more for mental health, I get centered, understand what's in front of me for the day. I know the day is gonna have some twists and turns, I get more energy from that etcetera too. I like to interact with people. I find that the human interaction, I'm a curious person, so the pandemic made a little more challenging. I was on the road often. Um I was then on the road none. So then you have to figure out how do you get the human interaction in a, in a very different way from that standpoint. And then lastly it's a commitment we talked about in our corporation, we're all in a lifelong journey of learning and so if you come to peace with that, that no one has all the answers, but this group has way more answers than this group has. You could, you could commit to a lifelong commitment around learning learning and that becomes very fulfilling from a personal being. So it's the physical activity, it's making the life trade offs in terms of calendar to make sure that um family and work are imbalanced. Um so coach, my son's assistant coach, I can't commit to being the full the head coach, basketball or baseball team that's as important as being in the boardroom to me. Um and watching young young men grow through that. So physical activity, a lot of interaction with people, lifelong commitment about learning. And lastly, I love what I do and I feel blessed every day to to run a global corporation, that the health service company that tries to change people's lives for the better. So I remind myself every day how fortunate I am. Um as opposed to how stressed I am. No, it's a blessing to be able to have that opportunity. Well, David, you are being incredibly modest. Let's end by you telling everybody how many triathlons you've run. Oh, so um last year was my 30th anniversary of racing was a means of recovering from an injury back in 1991. So over 30 years, about um six years ago we stopped counting. So it's 100 25 triathlons and um a significant number of marathons and half marathons, but but ironically in closing the last decade with the Achilles um Freedom Team, wounded veterans. I've run more half marathons and marathons during the last decade because of the opportunity to guide, which is made call it racing a totally different experience. The slowest runs I've ever done in my life, but the most rewarding by far and away. Um so back to mental well being and physical well being. That's more energizing than um some of the wonderful races have been able to do around the world over over a 30-year period of time. Thank you so much. What an inspiring session

David Cordani explains how the company plans to achieve that goal.

 Cigna CEO: We want to be the "undisputed partner of choice"

Leadership

David Cordani on how the company plans to achieve that goal.

Cigna CEO: We want to be the "undisputed partner of choice"

David welcome to On Leading and thank you so much for joining us to talk about a Signa. You know, for years people look at Cigna as a traditional insurance company. This is where you would get coverage for your medical services, dental disability, even life insurance. But um now the company is so much more than insurance. How would you describe cigna today? The easiest way to describe us as as a global health service company. So we're have the privilege of serving 175 million customer relationships around the world. And we're guided by our mission so that global health service company is guided by a mission of helping the people we serve improve their health well being and peace of mind. So to your point that's much broader than insurance. Um it's a service portfolio that helps individuals live a better life and live with more fulsome life. Well, you've made some significant acquisitions in the past few years. You bought express scripts which put you into the prescription drug business. Earlier this year, you bought a telehealth company, MG Live. So I guess you can say that cigna is as much of a health services organization as it is an insurance company, right? You bet the two combinations you referred to more strategic in nature. One express scripts, which has now been part of the Signal corporation for almost 2.5 years was oriented on our beliefs that that pharmacological innovation represents the next decade future of healthcare. Thinking about the way in terms of specialty medications, vaccines as we see them, gene therapies, be the curative or coping medications and services represent the future From that standpoint. Second, it expanded those we could serve through in addition to corporate clients, health plans and governmental entities. And third, very importantly, it dramatically expands the depth of data that we have to be able to be more predictive. And then with MD live, our view is that the another dimension of change in the health care arena is around the way in which we access care. So re envisioning the way in which care could be accessed, Not triage oriented telemedicine, but coordinated longitudinal virtual care. And I think a lot of people don't realize that Cigna is huge. The company is ranked number 13 on the Fortune 500 and you have a lot of cash on the book. So there's a lot of speculation. You can get even bigger by buying other companies. What do you want cigna to be known for? And how do you want people to describe Cigna? Let's say 22 years from now, one of our strategic comparative says we want to be the undisputed partner of choice as large as we are. We're very grounded in the fact that we can't do everything ourselves. Conversely, we seek to partner with others and co innovate co developed to accelerate value and services. So we want to be viewed as a partner that could advance innovation, advanced services. And then, lastly from a community Stewart standpoint, if I think about even during the the last 13 months of Covid, we challenge ourselves to be guided by our mission to give back to our community, to be first to give back to our customers and clients in a very different, differentiated way to work with a health care professional partners who are dislocated. So we view ourselves less through the size dimension and more through the quality confidence, partnership and value creation dimension that we're we are responsible for delivering. Um, and we're excited about the future in front of us right now and what about affordability? Everybody wants affordable health care, What can I do to make that happen? So two examples of how we're able to help our customers, individuals have more affordable healthcare going forward. First and foremost, help individuals either stay healthy in the first place or lower the risk for becoming sick. Um the ability to do so in terms of keeping somebody from becoming a diabetic or having a coronary event exists and that's not only high quality of life for an individual, but from an affordability standpoint. Second, is when health care needs to be consumed, help individuals identify the highest quality medical professional that can deliver them the best overall service from a quality standpoint, which happens to be the best affordability, Those two series of actions well, they may sound obvious and easy on a highly personalized basis or not, but when we do it, we deliver great value for consumers and better affordability. Let's talk a little bit about the covid pandemic. I understand that signal was the first uh insurance company to announce that it would pick up the tab on all medical costs for its insured members who were being treated for the coronavirus, Disney's hospital bills, ambulance transfers, meditations, and even wait all the seeds on a cost sharing payments. Why did you do that? And how do you feel about it now? I feel great about the decision we made at the point in time. The decision was made. Um in some ways it was a hard decision because the data didn't exist to tell you how much it was going to cost or otherwise. But it was an easy decision for us. So why we made the decision, People were scared. There was massive uncertainty and guided by our mission around health. While being a peace of mind. The peace of mind dimension informed us. So we made the decision, we carry the policy forward. Um and then we work to advise our clients who were self funded, um what the benefits were from that standpoint. But looking back, um, it's a decision I'm quite proud of. And again, when those challenges happened, you're guided by your mission and our mission guided us to make the right decision there. Would you do it again, especially if the Health care Act you are correct in saying that there could be another serious wave of covid infections as we go forward. And as a society, we learn more about Covid, we're going to need to live with Covid on a go forward basis. Um potentially annual vaccines from that standpoint, like we live for the flu standpoint. So now that there's broader acceptance, there's broader therapies is broader understandings in most cases the products and programs and services cover those, but in the dis joint with a once in a generation global pandemic. I'm proud of the decision we made at that point in time, you wrote an op ed piece recently about the power and importance of living with intention. Tell us what you mean by that and what does intention mean for the new priorities? Yeah. So it's being purposeful creating the agenda versus having an agenda be projected on you, um, at the individual level and at a corporate level, but on a personal basis, having your plan around potentiality um is so important in terms of what you're going to seek to do and spend your discretionary time on versus not. So it's important whether in our company and our culture from an individual standpoint as well as this, from the corporation to guide you and to provide that compass. And what about you, David? What are the leadership lessons that you've come away from this whole pandemic? How has the pandemic influence the way that you're leaving cigna today compared to a year ago dependent lot more energy around communicating and engaging because the ability to physically come together um is going away and I'm a field based individual. So I would spend a lot of time in the field in the markets around the globe seeing my clients, my customers are business partners, my co workers, so the biggest change communication, more variable engagement, heavier listening energy even further. We talk about listening first stop, listen and understand. Don't project. I know the answer, Stop, listen and understand. And the virtual world challenges that in a very different way. So a meaningful amount of change I would suggest in terms of both where I work the way I work and how it works. But it's all in support of the team And trying to help our team be successful because we're serving the 175 million customer relationships every day.

How health crises in her family prepared her to lead the healthcare giant.

Karen Lynch's path to the C-Suite at CVS Health

Health

if that were your family. If that was your spouse, if that was your friend, how would you want to be treated? And how do we help people through that health journey? And that's what kind of fuels my passion around health care and making a real difference. I lost my mom when I was 12 due to suicide, and, um, I Then when I was in my early twenties, I lost my aunt. She had breast cancer and lung cancer, and I sat on my aunt hospital bed, not knowing what kinds of questions to ask, not knowing where to get help. As you think about health care, it's not easy. My sister actually diagnosed with breast cancer when I asked her, What are the doctors saying? She probably knew about maybe 15% of what the doctor actually said. Fortunately for me, I can say, Well, you know, let's let's think about it in pieces. But okay, let's talk about you know what the doctor said. Let's figure out the questions. We want to go back and ask the doctor. So let's make sure that we think about what alternative treatment plans there are, and because I have this, you know, understanding of the health care system. I'm I'm able to help her answer those questions. Not everybody has has a sister that's in health care, and more and more people should know how to navigate the healthcare system. My goal is to make those connections simpler, easier and more affordable. So it's personal for me. Quite frankly, I went to, um, into health care while my aunt was sick. I spent a long part of my career 18 years of my career at one of our competitors increasing, um, successful, you know, increasing, um, responsibility rolls. They plucked me out of my finance job and put me in a human resource job. And the human resource job was working for the C F O S H R person. I learned how much time the CFO of the whole company was spending on people. People are the most important thing that you really need to understand and how to motivate them, how to inspire them, how to pay them how to train them. That was a step level job for me, and I did you know, I didn't do it for very long, but it taught me a lot about, uh, the human side of the business. When I came to Aetna, I came in and did the Coventry acquisition. It was one of their largest acquisitions at the time. They had a failed transition When they brought us healthcare. People in the company still remembered that I remember my first thing was going to all those individuals asking them Why did it fail? And you feel like it's gonna be difficult. Someone early in my career said, You have two years and and one mouth make sure you use them in proportion. Um, and and throughout my career, I really learned to listen. The chairman of the board called me and he said, We've gone through a process that, you know, you've been through the process, and I'm really pleased to let you know that we have chosen and selected you to be our new CEO. And I was elated. My husband was in the room with me when he called me. This is what I had hoped for. This is what I've worked my entire career for. And, um, it wasn't easy. There are a lot of obstacles along the way and really excited about the opportunity. There is no Harvard Business Review article. There's no owner's manual for how you're going to handle this global pandemic. We've been working with vaccines, Uh, for a number of months now. We were working closely with operations, warp speed and the States for a number of months. We are ready for the vaccine distribution. We've been mobilizing people. We've been mobilizing places, and we're spending a lot of time. We've hired 15,000 technicians. We have over 90,000 immunize ear's. Nationally, we have multiple access points for consumers to engage. We have the opportunity to utilize all 10,000 of our pharmacies. 40,000 long term care facilities have selected, uh, CBS. We are heading every milestone that we said we were going to hit. And I give a lot of gratitude to the scientists at Pfizer and Moderna and J and J for what they've been able to accomplish If there's one thing the pandemic showed us with the vulnerabilities in America and the vulnerabilities of the health care system, CBS has an opportunity now to be on the path to help fix some of those issues in the health care system. And we're like sprinter sitting on the starting line and, you know, we're ready to go. And that's how I feel like Okay, we're ready to go, um, put us in the game.

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