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Cigna's Evernorth and Kaiser Permanente team up to expand coverage for remote employees

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·Senior Reporter
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Portland, Oregon - March 29, 2011: Kaiser Permanente Prescription Bottle. Kaiser Permanente is a health care provider creating a network of physicians and medical professionals for the use of their members.
Portland, Oregon - March 29, 2011: Kaiser Permanente Prescription Bottle. Kaiser Permanente is a health care provider creating a network of physicians and medical professionals for the use of their members.

Cigna's (CI) Evernorth unit and Kaiser Permanente are joining forces to creatively serve a more remote workforce in a broad, five-year agreement announced Tuesday.

The deal gives Kaiser plan members access to the national insurance giant's PPO provider network while traveling outside of Kaiser's service area and makes Evernorth's specialty pharmacy, Accredo, Kaiser's preferred external pharmacy.

Evernorth president and CEO Eric Palmer told Yahoo Finance the pandemic-generated "new normal" helped forge the relationship.

"I think the opportunity for us to help Kaiser with a workforce that's increasingly nomadic ... is an opportunity for us to help make sure they can provide service for their customers, and its an opportunity for Evernorth to bring its services to more lives overall," Palmer said.

Dr. Arthur Southam, executive vice president of health plan operations and chief growth officer for Kaiser Foundation Health Plan, said the partnership is complimentary to its existing services.

Though Kaiser Permanente already serves eight states and Washington, D.C., the $93 billion revenue not-for-profit care delivery system and health plan partnered with Cigna to give traveling members access to covered urgent or emergency care.

The partnership is an easy one for Kaiser to plug into, as Cigna has built a reputation as being a brand-agnostic partner, compared to its competitors in the health insurance space. That was first evident when it acquired Express Scripts, which maintained relationships with competing plans.

"I think from a technology orientation perspective, I'll say we are working to be set up to have what I call an open framework and open architecture to be able to connect to all sorts of different players and partners throughout the industry," Palmer said.

Portland, Oregon - March 29, 2011: Kaiser Permanente Prescription Bottle. Kaiser Permanente is a health care provider creating a network of physicians and medical professionals for the use of their members.
Portland, Oregon - March 29, 2011: Kaiser Permanente Prescription Bottle. Kaiser Permanente is a health care provider creating a network of physicians and medical professionals for the use of their members.

"The health care ecosystem's got a long way to go, of course, but working to take friction, to take handoffs, and to make that more seamless is part of our orientation from a platform perspective," Palmer added.

Specialty pharmacy is an important cost driver and is why the relationship with Accredo is also important. Southam said that Kaiser already had a relationship with Accredo, but the new agreement helps it expand.

"Kaiser Permanent runs a very large pharmacy operation (including) PBM, mail order, in hospital and other. Our relationship (with Accredo) will help facilitate the availability of specialty pharmaceuticals, it will help control costs and therefore contributes to our shared objective for affordability," Southam said.

While the relationship benefits existing Kaiser members who are temporarily outside the coverage area, it will not apply to those who move out permanently, Southam said. Meaning, workers who are 100% remote outside the coverage area.

"For our core product, we, today, for regulatory reasons, do not write coverage for people who live permanently outside of that defined service area," Southam explained.

"I think the idea that we might, over time, have the opportunity to collaborate with Cigna on people who permanently reside outside our area, could be a possibility, but not today," he added.

"We've focused on the two main areas, specialty pharmacy and the out of area network, but we're just embarking on the broader discussion of where mutually beneficial opportunities are across the Evernorth portfolio," Southam said.

Follow Anjalee on Twitter @AnjKhem

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