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As market forces visibly disrupt healthcare (less access to cheap capital, reimbursement pressures, rising demand for services in the face of constrained supply), digitally transforming core processes is not merely an option any more. 

5 Core Beliefs Blocking Digital Transformation in Health Systems 

The winds of change swept through healthcare in 2017. Here’s what 2018 could bring. 

Five changes healthcare executives can expect in 2018

The Cigna Group released their revenue report for 2024 which showcased their 27% revenue jump to $247.1 billion — with Evernorth much to credit.

Evernorth, which includes pharmacy benefit services such as Express Scripts, contributed to the increase that clocked in at $195.3 billion in 2023.

David M. Cordani, chairman and CEO of The Cigna Group, highlighted Evernorth’s contributions during a conference call discussing the results.

“Evernorth continues to drive strong results in line with our expectations, primarily driven by our specialty and care services segment,” Cordani said.

The numbers highlight this statement, with pharmacy benefit services reaching $111.8 billion in adjusted revenue, a 46% jump from $76.8 billion in 2023.

Cigna's 27% Revenue Increase in 2024 and the Outlook on 2025

In addition, specialty and care services recorded $90.3 billion in adjusted revenue, marking an 18% increase from the previous year.

Evernorth's growth pattern has remained consistent, establishing itself as the backbone of Cigna’s financial performance.

As Cordani noted, Evernorth's leadership in biosimilars plays a crucial role in addressing major healthcare challenges.

For instance, the company introduced the Humira interchangeable biosimilar last summer, offering eligible patients access at $0 cost. 

By the end of 2024, nearly 50% of eligible Humira prescriptions were filled with biosimilars, and Evernorth is now extending this benefit to the interchangeable Stelera biosimilar.

Over the next five years, Cordani said approximately $100 billion in specialty drug spend in the U.S. will be subject to biosimilar and generic competition, positioning Evernorth to lead the way in delivering significant savings.

He also emphasized the growing need for affordable prescription drugs, especially with the rising use of GLP-1 medications, which have become a major driver of drug spending trends.

While these medications are relatively inexpensive to produce, U.S. patients are paying several times more than those in other countries, even with full pass-through rebates.

By advancing biosimilars and working to reduce drug costs, Evernorth remains committed to ensuring that patients can access medications at fair prices while maintaining long-term sustainability in the healthcare system.

Eric Palmer, president and CEO of Evernorth Health Services, highlighted in a 

, the organization's continued innovation in response to market demands.

"We know that healthcare and prescription drugs need to be more affordable, and coverage needs to be more transparent and less complex," he said.

To further enhance affordability, Evernorth has recently introduced several initiatives focused on cost transparency and patient protections.

These protections ensure that patients benefit directly from the savings Express Scripts negotiates.

For example, patients will no longer pay the high list prices for medications, and those in high-deductible plans will receive the lower prices negotiated by Express Scripts, even during the deductible phase when costs can be highest.

Beyond price protections, Evernorth is increasing transparency by offering personalized reports to patients, detailing their prescription drug costs, negotiated savings and plan-paid amounts.

Plan sponsors will also receive detailed, annual reports that provide greater visibility into pharmacy claims and costs than what is typically offered.

These efforts are part of Evernorth's larger strategy to make healthcare more affordable and transparent for all involved.

Adam Kautzner, president of Evernorth Care Management and Express Scripts, stressed that these initiatives are designed to ensure there are no surprises at the pharmacy counter.

A key factor in Evernorth’s innovation is the data-driven EncircleRx program, which expanded to cover about 8 million lives in 2024, Cordani added.

The program helps plan sponsors reduce costs and improve outcomes, with its Cardiodiabesity solution offering predictability in managing obesity, diabetes, and cardiovascular disease.

It also provides lifestyle support and tools to help patients on GLP-1 medications sustain long-term improvements.

Cordani expressed the importance of these solutions, especially given the rising costs of GLP-1 medications in the U.S.

"Despite these medications being relatively cheap to produce, Americans are paying prices that are multiples higher compared to other countries," he said. "This is not acceptable, nor sustainable."

Formulary Watch

Clinical

Evernorth Drives Cigna's Strong Revenue Growth and Focuses on Biosimilars and Drug Affordability

Potential threats to HIV care and fallout over the next four years, according to Jose Abrigo, Esq. HIV project director at Lambda Legal Defense and Education Fund and Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in Washington, D.C.

The HIV Epidemic in Trump’s America

Less than a month into his presidency, Donald Trump has already stirred controversy with a flurry of new executive orders, including attacks on Diversity, Equity and Inclusion programs and today’s closure of the United States Agency for International Development (USAID) offices, which oversee foreign aid, HIV and AIDS care included.

, HIV project director at Lambda Legal Defense and Education Fund and 

executive director at the HIV+Hepatitis Policy Institute in Washington, D.C., to find out what else may be in store over the next four years.

Abrigo said he is worried about a revival of the 1873 Comstock Act, named for the anti-vice crusader, Anthony Comstock. It prevents anything “obscene” from being sent in the mail. Abrigo said proponents’ priority is abortion but added that it could be used to target information about condoms or preexposure prophylaxis, both of which impact HIV care.

“HIV is so intertwined with racial justice and the LGBTQ community, and those are the two communities most at risk,” Abrigo said in the 

 interview. “An attack on people of color, especially Black women, and attacks on LGBTQ communities, especially the trans community, will disproportionately harm and hurt folks living with HIV.”

Schmid emphasized that his organization is working with the current administration to continue the Ending the HIV Epidemic in the U.S. initiative, which was set up under Trump.

“You can't take away healthcare from people living with HIV,” Schmid said in the 

 interview. “It is a lifetime requirement, and unfortunately, we don't have the private insurance, adequate private insurance, adequate Medicaid programs to ensure that people have that care, treatment, and the support services, the case management to make sure people stay adherent to their medications.”

Potential threats to HIV care and fallout over the next four years, according to Jose Abrigo, Esq., HIV project director at Lambda Legal Defense and Education Fund and Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

The Cigna Group announced a number of new initiatives as part of a “

t” to make healthcare easier for patients and doctors, improve efficiency and provide more transparency for its customers.

This follows the company’s recent earnings call, where executives discussed the organization’s growth and future plans, highlighting its focus on serving the best interests of their plan users.

Through these initiatives, Cigna is focusing on five key areas of simplifying healthcare processes, providing more resources to help customers navigate the system, offering better value through improved services, ensuring accountability through governance and sharing ongoing progress with the public.

To hold themselves accountable, the organization will tie executive compensation to improving customer satisfaction, as shared today.

Starting in 2026, the company will release an annual Customer Transparency Report to show how it’s progressing, including information about care facilitation and resolution statistics.

Cigna’s Chairman and CEO, David M. Cordani, stated in a news release that in a healthcare system that needs improvement, Cigna has to step up.

“The healthcare system in America needs to be better, and we have challenged ourselves to help lead and drive systemic change,” Cordani said. “We do a lot of good for many people, but we need to do better for everyone. We are committed to implementing tangible actions across our company to help drive better health outcomes and health care experiences.”

 the expansion of the “My Personal Champion” program to better support patients with serious conditions such as cancer, heart attacks and strokes.

This program will increase the number of dedicated advocates in aim help guide patients through both medical and administrative challenges.

In addition to expanding patient support, Cigna is also improving administrative processes for both patients and healthcare providers.

For example, new concierge teams will assist with prior authorizations and claims, helping doctors provide the necessary information to speed up care.

Patients will also be able to track the status of their prior authorization requests online.

Cigna is also working to make the submission process easier for healthcare providers, aiming to reduce delays caused by missing information.

In addition, Evernorth, Cigna's health services division, announced last week they will be focusing on improving patient access to affordable medications.

Through its Express Scripts pharmacy services, Evernorth plans to ensure that patients benefit from lower, negotiated drug prices, rather than paying the high list prices.

It will also provide personalized reports to consumers showing how they benefit from these discounts and offer plan sponsors annual reports on costs and pharmacy claims.

Cigna is also creating an Office of Excellence and Transformation to oversee these efforts.

David Brailer, M.D., executive vice president and chief health officer at Cigna, will lead the office, with Chris DeRosa, president of U.S. Government at Cigna Healthcare, overseeing its operations.

DeRosa will also continue managing Medicare businesses through Cigna’s acquisition with HCSC, which is expected to close soon.

With these new initiatives, Cigna is committed to improving the healthcare experience for its customers.

This follows the company’s recent earnings call, where executives discussed the organization’s growth and future plans, highlighting its focus on serving the best interests of their consumers.

Sanjeev Agrawal

Articles

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