OUR PARTNERSHIP FOR HEALTHIER GROWTH
PREPARED FOR
April 19, 2023
DARTMOUTH
Today’s Presenters
John Webb
President, Tri-South
Anne Slaughter
VP, Hospital and Health Systems Division
Sarah Sweer
VP, Network Management
Chuck Utterback
National Account Executive
Charles Green
Market Medical Executive
John Leslie, MD, CPE
Account Manager
Deborah Williams
Behavioral Clinical Strategist
Liz Gallus, MA, LPC, MHSP
Senior New Business Manager
Implementation Manager
Teresa Hunt
Client Service Executive
Millie Acosta
Director Client Service Solutions
Wendy MacDougall
Taking extraordinary action
in Extraordinary times.
Your Cigna Healthcare Team:
Day One and Beyond
Let’s start out on the same page to write your healthy workforce story.
St. Jude's
Client Experience
Affordable
Predictable
Actionable Data
Consultative
Enhanced Member and Provider Experience
Simple
You’re eligible for our pre-diabetes coaching program. We are excited to talk with you about the benefits of this program and get you enrolled.
Cigna Team
High-Touch Approach
Informatics
Collaboration with Stakeholders
Meeting your needs through a proactive and local approach
Informatics Team
Assess wellness metrics vs goals and best-in-class targets
Understand domestic utilization and leakage patterns
Identify cost drivers and plan opportunities
Two Dedicated Full-Time Positions: Service Coordinator and Behavioral Coach
The Cigna Team for St. Jude's
David Cordani President & CEO, Cigna Corporation
John Webb President, Tri South
Kelly Dill SVP, National Accounts
Charles Green National Account Executive
Customer Experience
Provider Experience
Clinical and Wellness
Health System Division
Millie Acosta, Client Service Executive
Teresa Hunt, Implementation Manager
One Full-Time Onsite Service Coordinator
Specialized call team with dedicated 800#
Provider Experience Liaison Tarshe Clayton
Chuck Utterback VP, Network Management
John Leslie, MD CPE
Informatics & Reporting Consultant
Communications support
Real-time redirection support
Thought leadership
Analyze utilization patterns with a Social Determinants of Health index
Executive Leadership
Provider Experience Liaison
Allison Hofmann National VP, Health System Division
Sarah Sweer VP, Health System Division
Informatics Consultant
Health Engagement Advisor
Dr. Shokea Miller DNP, FNP-C, Tri South Nurse Executive
Behavioral Health Strategist
Deborah Williams, Account Manager
One full-time onsite Behavioral Coach
Strategic Account Executive
Memphis
Then & Now
Hospital recontracting in 2021 led to a net decrease in total medical cost and one of the lowest (<1%) unit cost trends in the country Successfully converted several large providers to outpatient fixed payments. Fixed payments in facilities now account for 80% of spend, a 4% improvement, lowering outpatient rates Added an additional Cigna Accountable Care (CAC) provider that enhances value, quality and patient experience Contracted bundled payments with ASCs to incentivize movement to lower cost settings Major health systems’ facility drug and imaging reimbursements in-line with Cigna programs that focus on cost
• • • • •
Information as of 1/31/2022. 1. Projected market discount improvement for New Hampshire FY2020-FY2023, based on specific targeted actions. Cigna’s Forward Looking Discount Process has been certified as meeting actuarial standards by an independent, third-party actuarial firm, Cambridge Advisory Group. The certification is issued based upon a review of all stages of the discount projection calculation, including but not limited to: provider contracts, provider specific rates and development by major service area (MSA) and service categories. Confidential, unpublished property of Cigna. Use and distribution limited solely to authorized personnel. © 2023 Cigna Healthcare
1
Information as of 8/31/2022. 1. Projected market discount improvement for Memphis, TN MY2021-FY2023, based on specific targeted actions. Cigna’s Forward Looking Discount Process has been certified as meeting actuarial standards by an independent, third-party actuarial firm, Cambridge Advisory Group. The certification is issued based upon a review of all stages of the discount projection calculation, including but not limited to: provider contracts, provider specific rates and development by major service area (MSA) and service categories. Confidential, unpublished property of Cigna. Use and distribution limited solely to authorized personnel. © 2022 Cigna
3.1%
PROJECTED DISCOUNT IMPROVEMENT
Forward-looking Discount Improvement
Certified by an Independent Actuarial Firm
Projected market discount improvement for Memphis, TN MY2021-FY2023, based on specific targeted actions. Cigna’s Forward Looking Discount Process has been certified as meeting actuarial standards by an independent, third-party actuarial firm, Cambridge Advisory Group. The certification is issued based upon a review of all stages of the discount projection calculation, including but not limited to: provider contracts, provider specific rates and development by major service area (MSA) and service categories. Confidential, unpublished property of Cigna. Use and distribution limited solely to authorized personnel. © 2022 Cigna
Enhanced SPD Language
Flexible
Client Example
We hear you. And we're here to deliver.
Plan Design
WELCOME TO
Your Client Specific Network
A well-built solution designed to help you maximize domestic utilization and drive preferred physician engagement.
Here’s how.
DEDICATED
Dedicated Team
Flexible and Capable Approach
Deep Experience
HEALTHIER EMPLOYEES MEAN HEALTHIER GROWTH
Outcomes of a healthy workforce:*
45%
*The employer imperative: Driving US economic vitality through a healthy, productive workforce is an Economist Intelligence Unit report, commissioned by Cigna, that explores the role of employers in driving links between employee well-being and productivity, business success, and overall economic vitality in the US, particularly when considering the impacts of COVID-19.
YOUR NEW GROWTH PLAN
37%
greater productivity
stronger employee morale and motivation
greater retention and loyalty
A DAY IN THE LIFE OF
MARY
Today
You added your ID card to your Wallet.
X
Take your online health assessment – it’s quick and easy and can help guide you to better health. Bonus: It can earn you rewards too.
Friendly reminder:
Mary completes her online health assessment, and Cigna Healthcare gets to work. We review the data and identify two health engagement opportunities.
Mary doesn't have to worry. Cigna Healthcare offers a prediabetes coaching program and coverage for health screenings.
Both are at no cost. AND can earn Mary more rewards.
Mary is at risk for diabetes and due for her mammogram.
We give her a call to help.
8pm
Mary needs to schedule her mammogram but isn't sure which provider to pick..
We listen.
Digital convenience is critical. But sometimes a real conversation with a real person is too.
Your YNHH Employee Hotline is open 24/7
myCigna.com makes it easy.
We guide.
We go beyond.
To help keep your health on track.
Convenience and cost are her top priorities. She needs a provider who fits within her schedule and her budget.
We point her to find the right care, educating her about St. Jude's’s high-quality care at the best cost.
Post-wellness screening
Right care. Right cost. Unexpected diagnosis code. –
This could lead to a series of phone calls to get it sorted out.
Mary doesn't have time for that.
After Mary’s wellness screening
A better experience.
Mary calls Cigna Healthcare, surprised that she may have to pay a portion of her mammogram.
Cigna Healthcare contacts the provider's office to discuss Mary's question and request resubmission with the updated claim code.
After just one call, Mary's claim is resolved.
Mary can reach us anytime – 24/7/365.
8:00 pm
Even better news: It’s no cost to you AND it can earn you more incentives.
St. Jude's teammate
Find Care
Schedule
Earn Incentives
Follow-Up
Well-Being
Online
Mobile
Live Phone
In Person
Provider Search
24/7/365 Hotline
On-Site Service Coordinator and Behavioral Coach
Cigna Health Coach
Welcome
Our continued journey to total population health
Virtual Care
24/7 Access to high quality providers Primary Care Wellness visits including labs Specialty Care Behavioral Health Convenient access through the web and the MyCigna App
Enable all constituents to reach full potential
• • • • • •
Medical Management
Work directly with the dedicated informatics team
Take a consultative approach to enhance efficiency of plan
Collaborate and identify actionable areas to meet the unique needs of St. Jude’s members
• • •
Cigna Collaborative Care in Memphis
>10 years of experience with Collaborative Care in the Memphis area
Clinical Operations Alignment
Hospital vertical “Customized Personal Health Team” alignment Prior Authorizations Case Management Coordination of Benefits Appeal Process
Hospital vertical “Customized Personal Health Team” alignment
Approach data in a thoughtful and meaningful way
Well established partnerships with the highest quality providers
4 CACs with 45K aligned members and 369 providers
Alliance with Methodist LeBonheur Healthcare
Aligning programs and processes
Comprehensive MDLive solution to complement St. Jude’s growth plan
Because it’s needed now, more than ever – especially for health care workers.
RAPIDLY EXPANDING AND INVESTING IN BEHAVIORAL HEALTH
24/7/365 access to customer service and crisis triage support Fast, flexible access to quality providers Culturally competent referrals Virtual behavioral provider network, including Talkspace, Ginger & MDLIVE* Personalized coaching support Free mental health educational seminars and training
*Cigna unique provider data as of October 1, 2021
Mary doesn't have to worry. Cigna offers a prediabetes coaching program and coverage for health screenings.
PLAN
A seamless transition for implementation
Deliver draft contracts and agreements Monitor Cigna resources to ensure successful build of systems Deliver on-boarding training
Align Cigna resources for implementation and ongoing service Design custom implementation schedule Lead implementation and all future benefit changes
Review benefits and confirm St Jude’s intent Finalize employee communication Verify claim systems with test processing Coordinating end-to-end audit Establish online billing and payment
Validate delivery of all elements of program requirements Finalize all contracts and agreements Coordinate third-party vendor interactions
CONFIRM
EXECUTE
DELIVER
Vendor integration
Cigna partnership with Premise Administration
• •
We’ll take care of coordination with vendors
Onsite Clinic
Administration
FSA
•
Integration with vendors
Cobra
Valuable connections
• Bi-annual forums for health systems • Ongoing webinar access • Open forum for information sharing among health systems
• Case studies and research • Pilot programs
Insights and innovation
• Dedicated health care vertical executive leadership team • Dedicated health system call center
• Digital tools catered to the specific needs of health systems • Analytics designed specifically for hospital clients
People and processes
Not just support. A whole support system.
Tap Into The Cigna HealthCARE System Community
strong foundation
hospital system expertise
local strategy
our commitment
We're with you every step of the way.
Welcome,
NorthShore – Edward-Elmhurst Health PROVIDERS
A partnership built on trust so that your practice never misses a beat.
Dartmouth Health
We’ll continue to listen and ask the right questions to meet your goals.
Enhanced member health care experience – and health
Are Cigna Healthcare’s support tools and resources working in concert with your tools?
Quality-based outcomes
Are we helping providers deliver a quality visit, giving them the tools at their fingertips to make it possible?
Lower costs
Are we driving more utilization of your facilities and preferred providers?
Let’s keep going – growing – and innovating – together.
Advanced Analytics Go-to-market Pilots
STRATEGIC PARTNERSHIP
flawless execution
SUPERIOR CUSTOMER SERVICE & PROVIDER EXPERIENCE
St. Jude
HEALTHY EMPLOYEES.
Fueling our partnership for healthier growth.
HEALTHY SYSTEM.
HEALTHY COMMUNITY.
THANK YOU
client experience
customer journey
provider community
network
support system
stats
cover page
What We’ve Accomplished
Where We Are Going
Established local market infrastructure and invested in talent Strong foundation of value based programs Executed on multi-year strategy to be market competitive
Industry leading trend Refinement and expansion of existing value based models Development of solutions specific to local market dynamics
Network Strategy
CHICAGO Area
THE CIGNA EXPERIENCE FOR
YOUR
PROVIDERS
