BLOOMFIELD, Conn., 07 February, 2019 – Global health service company Cigna has exceeded
its value-based care goal of having 50 percent of U.S. Medicare and commercial health care
provider payments through alternative payment arrangements in the company’s top 40 markets
by year-end 2018. Cigna established the goal in 2015 to accelerate the transition to alternative
payment models that link health care provider payments to both quality and affordability.

Cigna launched value-based care delivery a decade ago to begin to transition to a health care
delivery system that pays health care providers based on improved health outcomes instead of
the traditional fee-for-service model, which pays providers based on volume. The move helped
the company shift 50.5 percent of provider payments to alternative payment arrangements, and
improve the quality of health care for customers resulting in medical cost savings of more than
$600 million from 2013-20171. In addition, it has contributed to Cigna maintaining the industry’s
lowest medical cost trend for six consecutive years2.

“Cigna’s focus on quality and affordability enabled the company to exceed its 50 percent
alternative payment goal, offering more value for our customers’ and clients’ health care
dollars,” said Scott Josephs, MD, chief medical officer at Cigna. “This is a critical milestone as
we work to accelerate the pace of change in health care delivery in the United States. Our
commitment to value-based care and alternative payment models is driving better health
outcomes, increased affordability and improved patient experience for the people we serve.”

Today, more than 3.6 million Cigna commercial customers access value-based care through
240+ primary care provider organizations, 500+ hospital facilities and 270+ specialist programs
in six disciplines, including 245+ Episodes of Care programs3. Ninety-six percent of Cigna
customers in the company’s top 40 markets are within 15 miles of at least three participating
primary care providers4. In addition, 85 percent of Cigna Medicare Advantage customers access
care through value-based arrangements2.

Cigna’s transition to value-based health care delivery has resulted in significant improvements in
health care for its customers. Top-performing accountable care program health care providers
demonstrated a quality performance of 11 percent better than the market5 with 92 percent of
providers either meeting or exceeding quality benchmarks6. Cigna collaborates with participating
providers who receive clinical support, data and insights to help improve health outcomes.
According to a survey7 of Cigna commercial accountable care program providers:

• 92 percent say the insights and guidance Cigna provides help them improve performance
and outcomes.

• 95 percent say their relationship with Cigna is collaborative and consultative rather than
transactional.

• 95 percent say it is easy to do business with Cigna.

“Cigna’s combination with Express Scripts will further accelerate our transition to value-based
health care, including expanding outcome-based relationships with pharmaceutical
manufacturers to incentivize improved patient health,” said Dr. Josephs. “Cigna has led its
industry with the lowest medical cost trend and our combination will help improve both quality
and affordability.”

About Cigna
Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the
health, well-being and peace of mind for those we serve. Cigna delivers choice, predictability,
affordability and quality care through integrated capabilities and connected, personalized
solutions that advance whole person health. All products and services are provided exclusively
by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life
Insurance Company, Connecticut General Life Insurance Company, Life Insurance Company of
North America, Cigna Life Insurance Company of New York, Express Scripts companies or
their affiliates. Such products and services include an integrated suite of health services, such as
medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related
products including group life, accident and disability insurance.

Cigna maintains sales capability in over 30 countries and jurisdictions, and has more than 160
million customer relationships throughout the world. To learn more about Cigna®, including
links to follow us on Facebook or Twitter, visit www.cigna.com.
1  Cigna January 2019 analysis of national Accountable Care program groups with effective
dates from 2013 through 2017. Reimbursements already paid to groups are subtracted from
the savings to reflect overall investment.

2   Cigna Corporation Investor Presentation, February, 1, 2019.
https://www.cigna.com/assets/docs/about-cigna/CI-investor-kit.zip.

3  Cigna internal analysis of existing arrangements as of December 2018.

4  Cigna August 2018 analysis of national medical book of business customers in the top 45 US
markets, defined by market size, within 15-mile zip code radius (zip code to zip code
distance of provider main office location) of three Accountable Care program physicians.
Subject to change.

5  Cigna June 2018 analysis (weighted average) of top five national Accountable Care program
groups per metric compared to local market in 2017. Accounts for 23,405 aligned customers.
Comparisons to market are established using Cigna internal claims data.

6  Cigna June 2018 analysis of 2017 data of Accountable Care program groups nationally,
active at least one year.

7  Cigna Accountable Care Organization (ACO) Experience Survey, September 2017.