The global health company will embark on a multi-year effort to provide easier access to care, better support and value, accountability, and transparency. One key area that it will address immediately: Prior authorizations.
The changes, announced Monday by David M. Cordani, chairman and CEO of The Cigna Group, are meant to build a better and more sustainable health care model.
“The health care system in America needs to be better, and we have challenged ourselves to help lead and drive systemic change,” Cordani said in a statement. “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."
Cigna, which last year began to scale back its Medicare Advantage footprint, will take specific actions to make processes simpler, easier, and faster, offer customers with better support and resources, drive better value, improve accountability, and openly share how it is continuously improving.
Specific changes include:
- Tying leaders’ compensation to customer satisfaction
- Publishing an annual customer transparency report, beginning in early 2026, which will include information on customer care, services, and resolution statistics
- Expanding its customer advocate team for patients with the most challenging complex conditions, such as cancer, to help them better navigate their care and treatment
- Investing resources to help more customers and patients quickly resolve administrative needs with prior authorization and post-care claims
- Introducing an enhanced digital status tracker that patients can use for prior authorization updates
- Encouraging physicians to communicate electronically about prior authorizations and claims through Cigna Healthcare’s digital provider portal to expedite approvals and reduce error
New ways to ease the prior authorization process
Cigna Healthcare, the health benefits division of The Cigna Group, provided more details in a separate announcement about its plans to improve the prior authorization process within its employer-sponsored plans and plans offered through the Affordable Care Act (ACA) marketplace.
Insurers use prior authorization to review, approve or deny medical procedures, services, or medications to control costs.
Cigna said it will establish a new concierge team to support customers experiencing challenges with prior authorization or with claims payments. A concierge will work directly with the customer’s physician to resolve any information gaps that require resolution, helping to prevent stress or confusion for the customer. Cigna also said it would accelerate and simplify the process for physicians to submit claims and prior authorization requests.
One of the most common reasons that a prior authorization decision is delayed is because of incomplete information in the initial submission, according to Cigna Healthcare. To help correct this issue, Cigna said it will expand digital communication options for physicians, including through its provider portal or directly through the electronic medical record. This will give physicians an easier way to submit all the necessary information the first time, improving turnaround time and accuracy.
“We want to reduce the burden on our physician partners by making it easier to submit a complete authorization request quickly and correctly the first time, expediting the path to getting needed services approved and giving providers their time back so they can invest it in what matters most: patient care,” said Dr. Amy Flaster, chief medical officer, Cigna Healthcare. “
Actions to address medication costs
Evernorth Health Services, a subsidiary of The Cigna Group, has also announced steps to address Express Scripts’ patient access, affordability, and transparency.
The company said that standard offerings will now protect patients from paying the high list price of their medications, ensuring they benefit from the lower price negotiated by Express Scripts. Patients in employer-sponsored plans will also have improved financial predictability, receiving the benefit of savings negotiated by Express Scripts if they don’t already.
As part of this broader effort, the company also committed to providing an annual personalized summary to customers about how they benefit directly from the discounted prices Express Scripts negotiates and providing an annual standardized report to plan sponsors disclosing costs and pharmacy claim-level reporting