And while individual customers aren't Cigna's forte, the insurer hit its small goal, capturing about 25,000 consumers in its exchange debut. It's not much to brag about, attracting just 7 percent of the roughly 351,000 people who have signed up statewide since enrollment began in November. But it's a jump-start for Cigna, which wants to shake up both its business model and the Blue Cross & Blue Shield-dominated Illinois market.
The bulk of Cigna's Midwest business is midsize and large employers, including the Chicago Transit Authority, which left Blue Cross for Cigna three years ago. "My goal is to continue to go deep into other pieces of the puzzle and figure out the value proposition I'm offering the market," says Michael Phillips, Chicago-based president of Cigna's Midwest market, a five-state network that includes Illinois. "A piece of that is the exchange."
While other insurers are fleeing Illinois' public exchange, Phillips, 52, sees it as ripe for experimentation, even as health care organizations and consumers brace themselves for tumultuous changes under a Trump administration. The Republican president-elect and his party-controlled Congress have vowed to repeal the landmark health reform law known as Obamacare, which created public health insurance exchanges nationwide four years ago.
For Bloomfield, Conn.-based Cigna, 2017 could usher in even more sweeping change: a merger with Indianapolis-based Anthem to become the largest insurer in the nation. The U.S. Department of Justice is vigorously fighting the marriage, for now.
Cigna is known for helping companies and their workers tackle medical costs by offering programs that focus on expensive and time-consuming diseases like diabetes. The insurer was an early adopter of paying doctors and hospitals to focus on prevention by hiring care coordinators to better track patients and keep them out of the hospital.
Phillips mentions some successes, cutting hospital admissions by 17 percent year over year at northwest suburban hospital network Amita Health; reducing blood sugar levels among 1,200 employees and their family members at Mulzer Crushed Stone in Tell City, Ind.; and helping 79 percent of employees at New York advertising software firm Media-ocean, which has a Chicago office, meet their cholesterol goals.
While many insurers share claims data to help physicians keep closer tabs on how their patients use medical care, Amita executives tout the depth of data Cigna provides. For example, Cigna tells Amita which employers have the most people who see its doctors. That can help Amita open clinics and offer programs closer to where those patients work. "We don't get that information from other (insurers) in the market," says Ryan West, vice president and chief operating officer of population health at the Arlington Heights-based hospital network.