Moving Health Forward Through Public Policy
Americans should not accept anything less than a health system that makes the treatment, prediction, and prevention of disease easier and more accessible. Choices by federal and state policymakers can either advance or limit our ability to achieve this vision. It is critical that we align public policy to deliver on the promise of better health care for all Americans.
Evernorth’s What’s Possible offers policymakers and other stakeholders a better understanding of some of the greatest challenges in health care and ideas to make our system more efficient, predictable, accessible, and connected. We seek to contribute honest analysis and thoughtful solutions as we strive to achieve What’s Possible in health policy.
What is Evernorth?
The health challenges of today and tomorrow require innovative thinking. Whether progress means something big or small, connected and efficient health services ensure people have the endurance to keep moving forward. As champions for affordable, predictable, and simple health care, Evernorth brings bold solutions to solve the problems others don’t, won’t, or can’t. Through What’s Possible, we are offering our vision for how we can better align public policy to deliver on the promise of better health care for all Americans.
Evernorth Health Services, a division of The Cigna Group, is powered by four seamlessly connected capabilities: pharmacy, care, benefits and intelligence solutions.
Pharmacy+: With our pharmacy solutions, we manage services for needs across the full pharmacy spectrum, from daily prescriptions to specialized therapies for complex conditions provide flexible clinical support options and distribution services.
Care+: Our care solutions connect individuals to convenient health solutions – either virtually or in person – that deliver optimal outcomes.
Benefits+: Our pharmacy and medical benefits solutions help drive greater affordability while increasing patient safety and clinical quality.
Intelligence+: Through advance analytics, predictive models, and tailored insights, our intelligence solutions helps to unlock opportunities and value, for both our clients and patients.
Learn more at Evernorth.com
How We Handle Pharmacy Benefits
Patients and policymakers are rightly concerned about the cost and accessibility of prescription drugs. These challenges call for a host of reforms, and our focus is on making health care more affordable, safe, reliable, and accessible for payers, providers, and, above all, patients.
Express Scripts, our pharmacy benefit management company, leverages patient-centered solutions to deliver medications safely, effectively, and affordably to more than 100 million patients. We use our unique expertise navigating the specialized field of prescription drug benefits and delivery to stand on the side of patients by negotiating discounts and rebates with drugmakers and retail pharmacies. This saves patients, their health plans, businesses, and federal and state governments billions of dollars each year. On average, pharmacy benefit specialists (sometimes called pharmacy benefit managers, or PBMs) reduce drug costs by nearly $1,000 per patient every year. We also advocate on behalf of our patients to increase access to life-saving drugs and improve health outcomes. At the same time, our expert pharmacists help keep patients safe by preventing medication errors and avoiding dangerous combinations of different medications.
Pharmacy benefit specialists, including Express Scripts, play a critical role in patients receiving the prescription drugs they need. We are the only part of the supply chain consistently delivering patients lower costs and increased access. At Express Scripts, we drive affordability and improved outcomes through a clinical-first approach, negotiating the lowest net cost of prescription drugs after first evaluating each medication on its clinical merits. We also offer a vast array of services to deliver better, more efficient care, such as promoting generics and biosimilars, developing formularies and pharmacy networks, managing high-cost specialty medications, and offering home delivery services.
Without pharmacy benefit specialists like Express Scripts, drug prices would be significantly higher, and too many life-saving medications would be out of reach for those who need them. This is why we need policy solutions that advance and protect the use of private sector solutions, while not eliminating or restricting the ability to negotiate lower overall costs.
Connecting Individuals to Convenient Health Solutions
Evernorth’s Care+ solutions include behavioral care, care delivery, and care enablement that can be accessed in-person, at home, at work, virtually, and digitally. Our innovative care models apply a data-driven and clinician-informed approach to predict emerging health needs, close gaps in care, and drive cost savings all while delivering simpler, more connected experiences.
Behavioral Health: Our behavioral health solutions span the spectrum of support – from network, access, and utilization management to intensive coaching – to treat conditions ranging from depression and anxiety to specialties such as substance use, autism, and eating disorders.
Care Delivery: Our care delivery offerings connect people to the right care, at the right time, in the right setting that is most convenient for them. Solutions include virtual care, primary home care, and direct health care.
Care Enablement: Our care enablement solutions provide connected care models and integrated platforms to deliver more precise, impactful clinical interventions. Offerings include clinical pharmacy solutions; post-acute and home-centered care networks; and wellness, coaching, and case management.