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


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

Conferences

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