Dear Shareholders,
Our vision for the health care system is built on the vitality of every individual and every community, and this means delivering on the promise of:
- Personalized, digital-first health care access and experiences at scale;
- Advanced care models for conditions, diseases and episodes with superior value; and
- Seamlessly connected pharmacy, medical and behavioral health services.
This is what we are working toward by harnessing the capabilities within our company and convening others through relationships with our partners. It is also what drives and fuels the passion of our more than 70,000 co-workers around the world. We all recognize the inevitable day each of us, or a loved one, will need to turn to the health care system with our own health challenge. Given the level of talent, capabilities and expertise we possess as a company, we view it as both our responsibility and our privilege to ensure the health care system responds by keeping good health and, therefore, vitality in reach for everyone. We will continue to support the health and vitality of customers, patients, clients and communities in ways that drive all of us forward in connecting for a healthier future.
Our results and progress
To fulfill these commitments, we have continued to strengthen and evolve our capabilities, and we also have refreshed our brands to reflect the unique value we bring with our broad portfolio. The Cigna Group is the new name of our corporation, and we bring our mission and vision to life through our two growth platforms, Evernorth Health Services and Cigna Healthcare. Guided by our durable strategic growth framework, we leverage our platforms as we work each and every day to fulfill our promises to our key stakeholders.
In 2022, both Evernorth Health Services and Cigna Healthcare delivered strong value for the benefit of our customers, patients, clients and partners, and, as a result, we achieved strong financial results for our investors. Our company:
- Grew total revenues to $180.5 billion.
- Achieved shareholders’ net income of $6.7 billion, or $21.30 per share, and adjusted income from operations of $7.3 billion.
- Returned $9 billion to shareholders via a combination of share repurchases and dividends.
EVERNORTH HEALTH SERVICES
Evernorth Health Services performed well in 2022 with its Pharmacy Benefits Services, Specialty Pharmacy and Evernorth Care businesses providing market-leading innovation and affordability. Throughout 2022, Evernorth Health Services continued to drive a digital-first approach to care with MDLIVE serving as the engine for virtual care. Last year alone, total MDLIVE patient visits grew by approximately 20 percent, including substantial growth in the virtual primary care program we introduced. Today, MDLIVE offers virtual primary, urgent, behavioral and dermatological care, which is expanding access, enhancing experiences and improving affordability for customers.
Evernorth Health Services’ pharmacy solutions are also increasing the value of each dollar spent on medication and driving to the lowest net cost while ensuring quality outcomes. The highest therapy completion rates in the market are a key part of this success. This applies to specialty and gene therapy costs, which comprise as much as half of total drug spending even though specialty drugs are used by less than 2 percent of the population. Biosimilars offer growing opportunities to lower costs for patients, clients and partners, and our leading specialty pharmacy capabilities give us a differentiated position to create value. Today, approximately 7 percent of our specialty drug spend has a biosimilar or generic equivalent on the market, and this will likely increase to more than 25 percent by 2026. Over time, we believe this will translate to a $100 billion market opportunity. And we expect to manage almost $30 billion of this market opportunity, driving significant savings for patients and clients as more biosimilar equivalents come to market.
As a result of the value Evernorth Health Services is generating for the benefit of those we serve, we continue to be a partner of choice across health care and have established significant new relationships with Kaiser Permanente and Centene.
CIGNA HEALTHCARE
Cigna Healthcare, our benefits portfolio, includes our U.S. Commercial, U.S. Government and International Health businesses. Together, these businesses are delivering products and services that meet the needs of employers of all sizes as well as individuals.
In U.S. Commercial, we drove strong growth, demonstrating how much clients appreciate our in-depth expertise and consultative approach, as well as the continued progress we are making with affordability. We are committed to being a differentiated partner of choice in helping individuals and their companies thrive in a time when employees increasingly are looking to their employers for health and well-being needs.
Our U.S. Government business provides an important growth opportunity for our company, and, in 2022, we continued to support individuals with plans for their personal health and well-being needs, for their lifestyle, and that fit within their budget. We continued our progress in strengthening our offerings as well as our work doubling the size of our Medicare Advantage provider network over the past two years. In our Individual and Family Plans business in 2022, we maintained our long-standing and continued commitment to participating in the ACA exchange marketplace, expanding our footprint and capabilities that provide positive experiences for those we serve.
Our International Health business contributed strong revenue and earnings in 2022. In addition, we completed the divestiture of our life, accident and supplemental benefits businesses across seven markets. We will continue to sharpen our focus on meeting the health and well-being needs in attractive growth markets and for the globally mobile.
Throughout the year, our Cigna Healthcare segment continued to find more ways of delivering value in the wake of COVID-19 as individuals and employers looked not only for medical benefits — they were looking for ways to increase their overall vitality.
CROSS-COMPANY COLLABORATION
Evernorth Health Services and Cigna Healthcare have delivered impactful results on their own. And, when they work together, they accelerate innovation and create new solutions for our clients and customers by leveraging our entire suite of capabilities, including our longitudinal portfolio of data.
Our Cigna Pathwell program is a prime example. Cigna Pathwell Specialty connects patients with convenient, quality and affordable options for drug infusions through Cigna Healthcare’s provider network. The newest Cigna Pathwell program, Cigna Pathwell Bone & Joint, connects patients to Cigna Healthcare’s provider network, as well as its personalized benefit designs, physical therapy options (both virtually and in person), behavioral health services and peer support. Through Evernorth Health Services’ analytics, our team can predict potential surgeries up to a year in advance and offer holistic care while also decreasing unnecessary surgeries that can drive up costs. When surgery is necessary, the members’ benefits will cover the procedure at low-to-no cost from admission to discharge.
Another example of the power of our cross-company collaboration is a new multi-year strategic relationship with VillageMD. Through VillageMD, we are transforming how care is accessed, delivered and coordinated for better health outcomes and affordability. Operating more than 250 primary care practices across 22 markets, VillageMD is one of the largest independent primary care groups in the United States. VillageMD physicians and patients partner closely with Cigna Healthcare and also benefit from Evernorth Health Services, including real-time data and clinical insights at the point of diagnosis, enhanced virtual care options through MDLIVE, and dedicated pathways to specialty care and condition management capabilities.
Making an impact
Our commitment to improve the health and vitality of those we serve guides how we operate our businesses, as well as how we engage and support our communities. We are honored by the recognition our efforts have earned, including being listed on the Dow Jones Sustainability Indices for a sixth consecutive year and ranking No. 1 within health care among America’s Most JUST companies by JUST Capital and CNBC.
In 2022, we continued to make strides across the four pillars of our environmental, social and governance framework: Healthy Environment, Healthy Society, Healthy Workforce and Healthy Company.
HEALTHY ENVIRONMENT
We see an inextricable link between the health of our environment and people’s health. This has spurred our commitment to do more. In 2022, we signed the RE100 global corporate renewable energy initiative and pledged to transition to 100 percent renewable electricity by 2030. In addition, we see an opportunity to measure the positive impact on the environment with a number of ways we are advancing our business. Telemedicine can help to reduce the carbon footprint of health care by reducing emissions because patients do not need to travel for care. Our continued investment in virtual care is one important way we will support a healthy environment.
HEALTHY SOCIETY
Recognizing that some communities face greater challenges than others in supporting the health of their citizens, we maintain our long-standing focus on reducing disparities, addressing social determinants of health and creating a more sustainable health care system.
We continue to advance our Building Equity and Equality Program, a five-year commitment to accelerate our health equity and DE&I efforts, and are particularly encouraged by innovative opportunities to address racial disparities in pre-term births. By working with health care providers and convening services that include free home delivery of prenatal vitamins, transportation for medical appointments, nutrition and emotional support, we aim to reduce disparities in pregnancy-related complications among African American women in Baltimore, Houston and Memphis, where we have launched our pre-term birth program.
We partner with providers to think beyond the clinical setting to best support the holistic care of their patients. We reward value-based providers to screen for social needs and make appropriate referrals for support and to identify health disparities impacting their patient population and develop an action plan to close gaps. We are also working to embed health equity into our culture, systems, policies and practices. Starting in 2021, we reviewed all our existing and new medical coverage policies through a health equity lens and, as a result, made changes to our policies that put us on the forefront of driving advancements in equitable access to care.
The commitment to our leadership role in making a positive impact in our communities is core to our business and embraced by our co-workers. Dr. Luis Torres is a shining example, among so many others across our company, of co-workers personally dedicated to making a difference. Dr. Torres worked to drive policy change addressing health equity for racial and social justice when representing The Cigna Group during the CEO Action for Racial Equity fellowship in 2022.
HEALTHY WORKFORCE
Within our company, we support transparency as we advance an inclusive culture honoring the unique talents and perspectives of our co-workers. Last year, we published our full-year 2021 Diversity Scorecard Report, reinforcing our commitment and progress in creating an environment where members of our team are able to bring their best selves to work, leaving us better able to serve the diverse needs of our customers, clients and communities.
Our Diversity, Equity & Inclusion (DE&I) Council continued to provide valuable leadership in guiding our DE&I strategy, helping us strengthen our approaches within our company and in our communities. Caring deeply about our customers, patients and co-workers is a value ingrained in our culture, and we are proud of the many ways our team brings this to life, including through our Community Ambassador Fellowship Program. Each year, we select up to 15 employees who receive paid leave and additional support to work with a nonprofit partner in addressing health and well-being needs. Our 2022 class of ambassador fellows worked on projects such as humanitarian and psychological support for refugees, help for adult survivors of childhood abuse, education around addiction, and the creation of equitable opportunities for high school students. We are encouraged by the impact we are seeing with our wide-ranging approach and are pleased to be recognized among DiversityInc’s Top 50 Companies for Diversity for a fifth year in a row.
We also understand the added challenges that many of our employees have faced over the past few years, and we have worked to increase the support we provide them. We initially offered emergency time off in 2021, and as the Omicron variant of COVID-19 spread rapidly at the beginning of 2022, we extended that benefit for our employees. In addition to increased flexibility, we also expanded our caregiver leave program to include care for grandparents and grandchildren in addition to children, spouses and parents with a serious health condition.
HEALTHY COMPANY
We have a deep and long-held commitment to strong governance as well as ethical and resilient business practices. The strength of our Board of Directors contributes meaningfully to upholding these commitments. Approximately 70 percent of our directors have served on our Board for fewer than six years, which demonstrates how we continue to bring new and relevant perspectives and skill sets into our company. Throughout 2022, our Board composition exceeded the S&P benchmarks on median age, tenure, gender and ethnic diversity.
Our company is purposeful about whom we work with as we seek suppliers that share our values and are committed to operating in a responsible manner. We continue to make progress in creating and supporting a diverse supplier base, and we are honored by the National Minority Supplier Development Council as being among the Forefront 50 corporations showing leadership in creating greater economic access and equity for systematically excluded entrepreneurs of color.
Building for the future
2022 was a strong year of performance, growth and positive impact for our company. With Evernorth Health Services and Cigna Healthcare, we demonstrated that we are serving the needs of our customers, clients and partners, and we expect to deliver another year of customer and earnings growth in 2023.
We are making a defining difference in health care, and we are committed to building on our momentum by taking on new challenges where we are positioned to lead. It is a profound privilege to lead more than 70,000 colleagues around the world who demonstrate personal dedication to our refreshed mission to improve the health and vitality of those we serve. I’m inspired by the way they guide patients to the care they need, work with employers in supporting their people and always seek more ways we can help.
Each and every day, we are bringing to life our vision of a better future, built on the vitality of every individual and every community.
Sincerely,
DAVID M. CORDANI
Chairman and Chief Executive Officer
The Cigna Group
Read the original letter here.
