Cigna's Evernorth, Kaiser Permanente team on improving healthcare access

Photo: Sam Edwards/Getty Images

Evernorth, Cigna Corporation's health services business, and integrated health system Kaiser Permanente are entering into a five-year collaboration for health benefit access and specialty pharmacy services.

Initially, the agreement will focus on two main areas. One is access to Cigna's PPO provider network for Kaiser Permanente members who need urgent or emergency care, and are traveling outside of the health system's service areas.

The second focus will be on specialty pharmacy services, with Evernorth president and CEO Eric Palmer calling it "an opportunity to unlock meaningful savings." The companies said the collaboration could potentially extend to more areas during the course of the agreement.

The broad agreement between the two organizations is effective immediately.

WHAT'S THE IMPACT?

Beginning in August, Kaiser Permanente commercial HMO and exclusive provider organization members who need urgent care when they are traveling outside of Kaiser's service areas will have access to Cigna's national PPO network of more than one million physicians and other providers.

This is expected to expand the health's system's ability to improve affordability and access for current and future members.

"This will provide our members an improved experience, added convenience, and greater confidence that if they get sick or are injured while traveling, they will have access to great care," said Dr. Arthur M. Southam, executive vice president of health plan operations and chief growth officer for Kaiser Foundation Health Plan and Hospitals.

In the area of specialty pharmacy services, the agreement seeks to deliver overall value and savings to Kaiser Permanente and its commercial plan members, the companies said. 

Accredo, Evernorth's specialty pharmacy, will become Kaiser Permanente's preferred external pharmacy for limited distribution drugs, and Evernorth's CuraScript SD will be a preferred distributor for purchasing certain other specialty products.

THE LARGER TREND

Cigna launched Evernorth in 2020 as a rebrand of its health services portfolio. In addition to Accredo, Evernorth includes pharmacy benefit manager Express Scripts, and eviCore healthcare, which provides utilization management services for health plans or employer groups and outpatient diagnostic-imaging service programs.

Its creation was part of a push to expand the business model to a broader market than just health insurance.

In February, Evernorth teamed with telehealth company Monument in an effort to make it easier for customers to access alcohol use disorder treatment through the latter's virtual platform.

Kaiser Permanente, meanwhile, experienced mixed financial results in 2021, with an increase in net income for the year but steep declines in operating income and operating margin. 

That didn't stop the health system from announcing this week that it would pledge $400 million toward economic development and housing. This doubles the nonprofit organization's financial commitment to its Thriving Communities social impact investment fund.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com