Leading through health care’s biggest moments of change

Elizabeth Gardner | March 17, 2019

Key Takeaway: The status quo in healthcare is not acceptable. Health epidemics, cost pressures and technological advances all require strong leadership.

One of the benefits of attending the Health Evolution Summit is the chance to listen to health care CEOs talk about the challenges they face. In April, 2018, David Brailer sat down with David Cordani to talk about the way Cigna is navigating today’s challenges and preparing for the future.

David Cordani became president and CEO of Cigna in 2009 and has spearheaded its transformation into a leading global health service company, doubling the size of the company in six years. He is a prominent voice addressing key health challenges, such as the empowering of individuals to manage their own health, innovating new health delivery models focused on patients’ health improvements, and partnering with physicians to focus on wellness and improve clinical quality. He joined Cigna in 1991, and has taken leadership roles involving critical disciplines of health care services, including distribution, marketing, clinical management, underwriting, finance and operations.

David Brailer, MD, is currently the chairman of Health Evolution. He has long promoted entrepreneurship in health care, particularly in the use of health information technology, and was appointed by President George W. Bush to be the first National Coordinator for Health Information Technology.

Cigna Corp., provides health insurance for more than 15 million people. It is taking an active role in promoting better health, establishing more than 200 collaborative accountable care arrangements with large primary care groups in more than 30 states, covering 2.4 million Iives and it has worked closely with physicians to reduce opioid abuse. The company recently diversified with the $67 billion acquisition of Express Scripts, a pharmacy benefits management company; the deal closed in December 2018.

Brailer: We are in perhaps the biggest moment of change in healthcare in decades. Cigna is one of the companies driving that change. How do you plot out where Cigna is going, and where the industry is going?

Cordani: We know the status quo is not acceptable. Whether you look at in the United States or globally, we have a health care crisis and an affordability crisis. How do we engage, support, and enable the individual? And how do we partner with an enabled health care professional to deliver more comprehensive continuity of care and, and engagement of care, and connect mind and body? We’ve delivered the lowest medical cost increases in the industry for five years in a row. We’re seeking to match the consumer price index, because we think that’s a sustainable level, and we believe it’s possible if we orient around health improvement, health engagement, and quality.

Brailer: Who do you think is going to harness and engage consumers?

Cordani: Even the most sophisticated employers with the most sophisticated consultants design benefits to work for the average of a population, even though no single person is “average.” If we designed benefits and network access individually, we would get the right value proposition for each person. And technologically, the capabilities exist to be able to do so today. Three years ago we offered a group of Cigna employees a chance to design their own benefits. Their benefits were about four percent leaner than the average, they understood them better, and they had exponentially more satisfaction.

Brailer: Obviously we’re in a period of enormous expectations for artificial intelligence and diversified data to help us improve the yield of our investment in healthcare. Where do you see real promise?

Cordani: I think our industry under-leverages the application of our structured data, even before we get to unstructured data and machine learning and AI. The longitudinal nature of our datasets is extraordinarily powerful. We have billions of consumer touch points. We are excited about our ability to see data on a whole person at a much more comprehensive level. We can apply the data for predictive purposes and sub-segmentation and targeting.

Brailer: What is the role of companies like Cigna as we address some of the social dilemmas that hit healthcare, such as obesity, or opioid dependency?

Cordani: We passionately believe that we have a responsibility that extends beyond our traditional business model and our shareholder responsibility. Take the opioid crisis. We decided to step in, and convened forums in major cities around the country with policy leaders, faith leaders, community leaders, and business leaders. We supported work in those cities. And we made a very specific pledge that we would reduce the consumption of opioids for all of our customers. Not just our customers at risk for addiction, or in chronic care, or taking opioids right now, but all of them, by 25 percent, within 36 months. And we did it in 22 months. And we’re proud of that. And that’s a negative ROI item, but we didn’t care. Nobody ever did the math in our company. It was the right thing to do.

To fight obesity, we chose to focus our energy on childhood obesity, kids between the ages of 5 and 12. We partnered with ChildObesity180 and Tufts Medical School because we want to get ahead of the curve. And we were able to partner with the Obama administration and the Department Of Education to show that you could improve not only the health of the individual but the behavioral issues with some individuals. Academic scores went up. We have to challenge ourselves to do more of that because these societal voids cannot be fixed solely based on political policy. We have a responsibility to step in.

Brailer: Could we talk about leadership? You’re running a huge global platform. You’re leading through change. What’s your recipe book?

Cordani: The CEO’s role is to make sure there’s a vision. There’s a plan. There’s a structure. You get the right people in the structure. You get the hell out of the way, and you support the heck out of your organization. That’s my basic recipe.

About the Author

Elizabeth Gardner, Staff Writer