Cigna looks to harness potential synergies between its health plan, Evernorth

As Cigna's Evernorth subsidiary continues to grow, the company is working to find synergies between its services and it health plan, executives said on the company's earnings call Thursday.

CEO David Cordani told investors that Cigna sees three key areas for Evernorth to grow: pharmacological innovation, behavioral healthcare and alternative sites of care. For example, in June, Cigna announced it would offer financial incentives to eligible members who switch to lower-cost biosimilar drugs.

Strategies like this will become increasingly important as more high-cost products come to market, Cordani said. Evernorth includes Cigna's Express Scripts pharmacy benefit manager as well as Accredo, its specialty pharmacy arm.

"This illustrates just one way we will continue to leverage Evernorth’s capabilities to drive greater affordability and value for our Cigna Healthcare clients and customers," Cordani said.

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A growing biosimilar market that challenges market share for pricey, popular brand drugs is a trend that Cigna is watching closely, and Cordani said these new therapies represent an opportunity to reduce healthcare costs by $100 billion.

"We are positioned to lead and fully intend to capture a large portion of those savings," Cordani said.

Cordani said another area where Evernorth's capabilities could be harnessed in Cigna's health plan business is virtual care, particularly for behavioral health. Cigna closed its acquisition of telehealth provider MDLive in April 2021. Ensuring patients with behavioral health needs can access sustained and effective treatment could also significantly drive down healthcare costs, Cordani said.

Cigna brought in $1.1 billion in earnings for the fourth quarter, down from a $4.1 billion haul in the same period in 2020.

Revenues for the quarter were $45.7 billion, up from $41.7 billion in the prior-year quarter, the company said in its earnings report (PDF) released Thursday. Both figures exceeded Wall Street's expectations, according to Zacks Investment Research.

For full-year 2021, Cigna earned $5.4 billion in profit and $174.1 billion in revenue. By comparison, the insurer raked in $8.5 billion in profit for 2020 and $160.4 billion in revenue.

“We performed well in 2021 as we supported the growing needs of our clients, customers and patients,” Cordani said in a statement. “2022 will be a year of growth across our franchise as we continue innovating and advancing our work to make health care more affordable, predictable, and simple.”

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By the end of 2021, Cigna boasted 107.3 million pharmacy benefit customers, a gain of 8.4 million over the course of the year. Medical membership reached 17.1 million, a gain of 431,000.

Revenues at its Evernorth subsidiary, which includes its Express Scripts pharmacy benefit manager, were up 15% year over year in the fourth quarter, reaching $35.1 billion. Total revenues for 2021 at Evernorth were $131.9 billion.

At its health plan, revenues were up 8% compared to the fourth quarter of 2020, reaching $11.2 billion. Total revenues for 2021 were $44.7 billion.

For 2022, Cigna expects earnings per share of at least $22.40 and revenues of at least $177 billion, according to the report.