Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast.
Thrilled today to be joined by a special
guest. Margo Curry is the senior director of
commercial medical clinical solutions and strategy
at Cigna Health Care. Margo, thank you so
much for taking the time to be with
me on the podcast today.
Jacob, it's great to be here. Thank you
for having me. Absolutely. Thank you so much
for taking the time.
We we're here to talk with you today
about a very important issue, but before we
dive into all of that and all that
we wanna talk with you about, can you
tell us a little bit more about yourself
in terms of your health care career background
and what it is that you do today
at Cigna?
Sure. At Cigna, I'm a product lead of
Cigna's medical clinical solutions and strategy.
And so in this role, I'm responsible for
our overall wellness programs, disease specific programs, medical
specialty drugs, and oncology.
I've been with Cigna for 6 years and
in various products and strategy roles for probably
over 25 years.
I live in San Diego with my husband
and 2 young girls. They're aged 46.
And ironically,
despite leading
Cigna's oncology program, in the summer of 2023,
I was given the shocking diagnosis
I had stage share breast cancer.
And how I found it was I was
going to a local concert with my husband,
I put on a tube cap shirt, we
were dressing up, and I felt some bumps
not even on my breast but in my
upper left chest. And I remember immediately showing
it to my husband at the time and
he had a very normal reaction which was,
hey, babe. You know, don't worry about it.
It's on your chest. It's not even on
your breast.
And
luckily,
I took action after talking to a friend
who encouraged me to see someone right away
and I did see my primary care
and very quickly got the unfortunate diagnosis I
had stage 3 breast cancer.
But this was a shock. I mean, Jacob,
I had no family, no genetic history. I
still don't even after they've done all the
rigorous testing.
I was healthy. I always bought organic. I
didn't smoke. I did my annual
visit, physician visits and checks. This was something
I thought I would never have to be
worried about.
And,
unfortunately,
you know, this is all too common of
people who get breast cancer. In fact, 85%
of the women who get breast cancer have
no family and no genetic history. So they're
in a state of shock just like me.
And
kind of in terms of my treatment, pretty
immediately,
I had to start a grueling
five and a half months of chemo with
some of the toughest chemo drugs in the
world.
Very quickly, I would shave my head and
then all of my hair. I had to
get a double mastectomy,
6 weeks of daily radiation,
followed by this summer I did a preventative
oophorectomy
and hysterectomy.
And I'll be on maintenance medication for years.
So this isn't something that is one and
done. This is massive life
altering. It's
massively costly. It's traumatic and it's, again, something
that's gonna be with me for life.
And
this was a big moment for me.
What can after going through this, even while
I was going through it, the entire time
I was thinking,
what can I do as a health care
leader who oversees our oncology
solutions and strategy
that help others?
How can I help them catch it early
so they are not going through this traumatic
and constant journey that I did? And if
they do go through it, how can I
share all of the tips and tricks and
everything I learned to make this process less
daunting?
Wow. I mean,
first, let me just say, Margo, thank you
so much for coming on today to to
share your story and your journey with us
because
it's so important,
to to get your message out there about
what you've experienced and what you've been through.
And then, as you said, translate that into
advocacy for better access to these services for
everyone
that Cigna serves. So so, again, thank you,
for taking the time to do this and
and to share your story with us.
I think the natural question to to everything
that you just shared, Margo, is why is
there such a pressing need for more breast
cancer screenings and support
for for the individuals that Cigna serves?
And has there been,
specific strategies or initiatives that you all have
found to be most effective in addressing these
issues?
Yes.
Absolutely.
When caught early,
breast cancer has a 99%
survival rate. The customer if a patient is
looking at kind of a relatively minor surgery,
a lumpectomy,
maybe a little bit of radiation,
versus everything I went through. When caught late,
like at stage 3, you have an 80%
survival rate. And when caught at stage 4,
you have a 30%
survival rate. So there is a massive
value proposition in catching this early, I mean,
patients can live.
So as I reflected on my experience, there
were 3 gaps that I really wanted to
tackle to help drive early detection.
And by the way, when you find cancer
early at stage 1 versus stage 4, there
is a 350%
cost difference.
So there's also a significant value prop for
our client.
So the first the first gap we wanna
tackle
was you could've heard this in the story
probably, but there's a massive lack of public
awareness about around breast health.
So
1 in 8 women will get breast cancer
and 85%
have no family and no genetic history.
That stat is not out there. Most women
think tune out. I don't have to worry
about this. I don't have it in my
family. I don't have to I don't have
the gene.
But every woman needs to tune in, and
this is why getting your mammogram
and continuing to get the mammogram
are so important. So that simple stat is
just critical to help raise public awareness.
As women, we're taught that there's one side
of breast cancer, that it's a bump on
your breast. But actually, there's
one side of breast cancer and the bump
can be anywhere below your collarbone.
And so at Cigna, we really wanna change
this to help women understand the importance of
getting their mammogram and of this breast health.
So we actually launched a few initiatives here,
Jacob. Some are small, some are bigger. So
in October,
this year, in light of breast cancer awareness
month, we put a a cute little bra
image with the message get your mammogram
on the inside of PillCap.
So every woman receiving a script from our
select facility who is over 40 received this
cute little mammogram.
In October and this was available to all
clients across the board at no cost. Also,
in October, we launched a text messaging campaign
targeting women over 40 who had not yet
gotten their mammogram.
This was done in partnership with our Evernorth
partners.
And lastly,
we launched this October across the board available
at no cost to all clients, a partnership
with a company called Know Your Lemons.
Know Your Lemons offers an award winning digital
experience
and educates patients on breath breast health, such
as the twelve signs of breast cancer and
that a lump can be anywhere below your
collarbone,
stuff that you don't hear anywhere else.
And what's cool about it is they use
lemon instead of breath. A lot of cultures
or individuals
don't feel comfortable looking or talking about breath.
And so the visual use of a lemon
is a way to help kind of break
through those barriers and still provide education.
And their visuals, if you go online and
check them out, they're just captivating.
And it's not just for women. So for
men, it's gonna teach them what to look
for. It's gonna teach them how to have
conversations with their wives, their mothers, their daughters
about the importance of breast health. And so,
again, when caught early, breast cancer has a
99%
survival rate. All of this matters.
And,
know your lemons has some pretty compelling results.
So
when they found in their study, the customers
who kind of go through the know your
lemons experience, they have a 24%
increase in mammogram
and a 34
percent reduction in stage 4 diagnosis.
And so we're also launching so that's a
free version,
but we have a at work know your
lemon solution. We're also launching 1 125
that clients can buy up at a minimal
cost, and that's for clients who really wanna
lean in. If you want client specific reporting,
gamification
to help encourage more engagement on this app,
That's what it does. It also provides every
single breast cancer diagnosed
customer with a box
called the dandelion box.
That box includes messages of hope. It teaches
them kind of how to get through with
tips and tricks. It explains the highly complex
landscape of chemotherapies
and lab results, etcetera, in easy to understand
ways.
So, again, the the first kind of that
was a lot, but all of these breast
health awareness programs
are really focused on driving early detection,
saving lives,
and lowering cost. I said that that there
were kind of 3, and so that was
one big big area we tackled pretty aggressively
here around breast health. But the second area
was
it's great to provide awareness. We need to
do that. But there still exist some barriers
for why women were not getting their mammogram
or their preventive exam.
So one barrier we hope to tackle here
is financial.
So come 1126,
we're launching a new premier oncology benefit
where
if you need to get a breath
a a mammogram,
a colonoscopy,
maybe an MRI or an ultrasound because you
have dense breasts, maybe you need a mammogram
but you're not 40 or 30 or 35,
you know,
patients are getting cancer younger and younger, specifically
breast and colon cancer.
If you have a diagnostic and clinical reason
for needing to get these exams despite the
age,
this benefit will cover you with a $0
cost there.
So we're we're really excited about this benefit,
again, targeted at removing any financial barrier for
the customer.
We also understand
another barrier
is scheduling,
as simple as scheduling.
So we're launching a solution 1 125 of
this year just in a few months. It's
called our preventative care outreach model.
And this is going to if they buy
up, it is going to proactively call targeted
members
reminding them to get their mammogram.
It tells them why it's so important, but
it will help them get it scheduled, which
is we understand a significant barrier.
And
lastly, you know, we we can't stop we
at Cigna, we can't stop women from getting
diagnosed with breast cancer or any type of
cancer. But we can and what you hear
from me is we're encouraging and hoping to
catch it early.
But if it is caught late, like in
my experience,
and one of the things I learned is
that what was most helpful
was when I was getting breast cancer specific
guidance
from my oncology nurse advocate at Cigna.
Because each cancer diagnosis
is unique.
It comes with their own drugs, their own
side effects, their different tips and tricks to
manage the side effects, there's different challenges and
resources
available.
And so one of the shifts
we've made at Cigna is we understand
a one size fits all approach for oncology
will not work.
Instead,
we're taking a differentiated
approach.
So we are connecting
customers with personal oncology nurse advocates
who are highly trained and qualified, not just
in oncology,
but they're offering condition specific tips, for example,
in breast cancer.
So here's some of the kind of tips
and tricks they're gonna share with you, Jacob.
When you're starting chemo,
the last thing on your mind or a
patient's mind is their eyelashes and their eyebrows.
Right? Like, they feel like they're dying. And
yet, getting some advice upfront before you start
chemo to say, hey. Consider
getting your eyebrows tattooed because you're gonna look
like an eye you know, you're gonna look
like a cancer patient not because you don't
have hair, but because you have no eyebrows
and eyelashes.
So consider getting your eyebrows microbladed
to tattoo that lasts 2 years. It's just
a little tip that we share with patients.
We also share if you're being treated with
adreanmicin,
that's on ice while you're receiving that infusion
for 20 minutes because that can prevent these
awful mouth sores.
If you're getting treated for capsule infusions, it's
about an hour long, consider wearing you can
buy them off Amazon,
ice mittens and booties.
Doing this will help reduce and minimize the
risk of developing neuropathy in your hands and
feet, and that's for life.
And so and they also understand Cigna's wig
benefit and local resources for free bit wig,
helping connect women
through these resources to help them feel confident.
And so this targeted condition support is unique
in the health care industry,
and this approach, you know, it provides holistic
assistance to really address the customer's
financial, medical, pharmaceutical, behavioral health needs
throughout their entire journey.
So as you just detailed, Margo, there is
so much amazing work going on across the
Cigna enterprise in terms of being aware of
the signs and symptoms of breast cancer and
then being proactive
about
breast
health. Any other,
innovations
or approaches,
from Cigna that you'd like to share about
in terms of advancing support,
for for breast cancer services, Margo?
Yeah. So
we've talked a lot about the programs that
Cigna is due to support the customer and
help us find it early, but we also
understand for clients, oncology is still a major
cost. In fact, when I look at our
total spend across Cigna's entire book by condition,
oncology is often the number 1 or number
2 cost driver across all conditions.
And what's interesting when you look at total
oncology cost a little bit deeper, the number
one driver of total oncology cost are medical
specialty drugs, and they drive 35%
of total cost. And so Cigna has an
industry leading benefit in network to manage these
costs called possible specialty.
And clients can save 15%
off their medical specialty drugs then. This is
a significant
program
to move the needle in managing the cost.
From the customer lens,
customers are often redirected
to their home. So they're giving the option
of instead of receiving this infusion in a
high cost hospital setting,
you could instead not have to go anywhere
and receive this infusion in the comfort and
convenience of your own home. And in fact,
50% of the time when we make these
calls, customers elect to do that.
And so we're launching a lot in 2024
and 25,
but we're not done. I mean, oncology, it
remains a top priority,
and I'm so grateful
I can use my experience to help others.
And that the Cigna enterprise has really embraced
the advocacy
of survivor
to drive change.
Absolutely. Well, it sounds like a lot of
amazing things on the horizon, Margo.
Before we go, you have a lot of
other health plan leaders listening in from all
over the country.
Any final thoughts or bits of advice you'd
like to share with them in terms of,
helping better better manage their their members' breast
health and and catching these issues early on.
Yeah. The one thing we didn't talk about
it, that it's almost the step one and
gets often overlooked, Jacob, is when you are
diagnosed with cancer, but you feel like you're
dying. Literally, when you walk out the door
of that doctor's office or you hang up
the phone, you feel like you're dying. It's
very difficult to comprehend basic information.
You need significant behavioral health. And that's truly
kind of the step one. In fact, many
cancer patients as I talked as I connected
with cancer patients in my journey, they cited
the hardest part
was that first part of moving from diagnosis
to before starting treatment. And so Cigna offers
247 behavioral health support, the program called confide,
and it connects a customer to a licensed
telephonic clinician.
And this was one of the first calls
I made.
And this period,
it's a massive mental health challenge.
People cancer patients are haunted by the fact
that the cancer is spreading. It's here. It's
here. And that may very well manifest in
unnecessary
ER visits or additional high cost unnecessary
imaging.
And so being able to support these patients
from a behavioral health standpoint immediately
to manage this massive anxiety,
maybe sleeping challenges, maybe depression
can also significantly
help, manage costs and avoid unnecessary
medical treatment.
And so,
Cigna doesn't just offer and connect oncology patients
with support immediately,
but they can connect oncology patients with
oncology
specific
behavioral therapists
who understand
what it feels like to feel like you're
dying and facing a potentially
years long treatment plan
and
the fear of cancer coming back for life.
And this is really unique in the industry,
offering oncology specific behavioral support that we feel
it can make all the difference.
Fantastic. Well, Margo, I thank you so much
for sharing about your experience and your journey
with us and our listeners, and thank you
for sharing your insights on on how our
listeners can can turn your experience into actionable
actions
for for their members. We we really truly
appreciate it.
Thank you again for having me, Jacob.
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