Latest / Becker’s Payer Issues Podcast / A Personal Journey and Cigna's Innovations in Breast Cancer Support with Margaux Currie

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A Personal Journey and Cigna's Innovations in Breast Cancer Support with Margaux Currie · Becker’s Payer Issues Podcast

0:00
Hello, everyone. This is Jacob Emerson with the
0:02
Becker's Payer Issues podcast.
0:04
Thrilled today to be joined by a special
0:06
guest. Margo Curry is the senior director of
0:09
commercial medical clinical solutions and strategy
0:12
at Cigna Health Care. Margo, thank you so
0:15
much for taking the time to be with
0:16
me on the podcast today.
0:19
Jacob, it's great to be here. Thank you
0:20
for having me. Absolutely. Thank you so much
0:23
for taking the time.
0:25
We we're here to talk with you today
0:27
about a very important issue, but before we
0:29
dive into all of that and all that
0:31
we wanna talk with you about, can you
0:33
tell us a little bit more about yourself
0:34
in terms of your health care career background
0:37
and what it is that you do today
0:39
at Cigna?
0:40
Sure. At Cigna, I'm a product lead of
0:43
Cigna's medical clinical solutions and strategy.
0:46
And so in this role, I'm responsible for
0:49
our overall wellness programs, disease specific programs, medical
0:53
specialty drugs, and oncology.
0:56
I've been with Cigna for 6 years and
0:58
in various products and strategy roles for probably
1:01
over 25 years.
1:03
I live in San Diego with my husband
1:05
and 2 young girls. They're aged 46.
1:09
And ironically,
1:11
despite leading
1:12
Cigna's oncology program, in the summer of 2023,
1:16
I was given the shocking diagnosis
1:19
I had stage share breast cancer.
1:22
And how I found it was I was
1:24
going to a local concert with my husband,
1:26
I put on a tube cap shirt, we
1:28
were dressing up, and I felt some bumps
1:31
not even on my breast but in my
1:32
upper left chest. And I remember immediately showing
1:35
it to my husband at the time and
1:37
he had a very normal reaction which was,
1:40
hey, babe. You know, don't worry about it.
1:42
It's on your chest. It's not even on
1:44
your breast.
1:45
And
1:46
luckily,
1:47
I took action after talking to a friend
1:50
who encouraged me to see someone right away
1:52
and I did see my primary care
1:55
and very quickly got the unfortunate diagnosis I
1:59
had stage 3 breast cancer.
2:01
But this was a shock. I mean, Jacob,
2:04
I had no family, no genetic history. I
2:07
still don't even after they've done all the
2:09
rigorous testing.
2:10
I was healthy. I always bought organic. I
2:13
didn't smoke. I did my annual
2:15
visit, physician visits and checks. This was something
2:19
I thought I would never have to be
2:21
worried about.
2:23
And,
2:24
unfortunately,
2:25
you know, this is all too common of
2:27
people who get breast cancer. In fact, 85%
2:31
of the women who get breast cancer have
2:33
no family and no genetic history. So they're
2:36
in a state of shock just like me.
2:38
And
2:40
kind of in terms of my treatment, pretty
2:42
immediately,
2:43
I had to start a grueling
2:45
five and a half months of chemo with
2:46
some of the toughest chemo drugs in the
2:48
world.
2:49
Very quickly, I would shave my head and
2:51
then all of my hair. I had to
2:53
get a double mastectomy,
2:55
6 weeks of daily radiation,
2:57
followed by this summer I did a preventative
3:00
oophorectomy
3:01
and hysterectomy.
3:02
And I'll be on maintenance medication for years.
3:05
So this isn't something that is one and
3:08
done. This is massive life
3:11
altering. It's
3:12
massively costly. It's traumatic and it's, again, something
3:16
that's gonna be with me for life.
3:18
And
3:19
this was a big moment for me.
3:22
What can after going through this, even while
3:24
I was going through it, the entire time
3:26
I was thinking,
3:28
what can I do as a health care
3:29
leader who oversees our oncology
3:32
solutions and strategy
3:34
that help others?
3:35
How can I help them catch it early
3:37
so they are not going through this traumatic
3:39
and constant journey that I did? And if
3:41
they do go through it, how can I
3:43
share all of the tips and tricks and
3:45
everything I learned to make this process less
3:49
daunting?
3:50
Wow. I mean,
3:52
first, let me just say, Margo, thank you
3:54
so much for coming on today to to
3:56
share your story and your journey with us
3:59
because
3:59
it's so important,
4:01
to to get your message out there about
4:02
what you've experienced and what you've been through.
4:05
And then, as you said, translate that into
4:08
advocacy for better access to these services for
4:11
everyone
4:12
that Cigna serves. So so, again, thank you,
4:16
for taking the time to do this and
4:17
and to share your story with us.
4:19
I think the natural question to to everything
4:22
that you just shared, Margo, is why is
4:24
there such a pressing need for more breast
4:27
cancer screenings and support
4:29
for for the individuals that Cigna serves?
4:32
And has there been,
4:34
specific strategies or initiatives that you all have
4:37
found to be most effective in addressing these
4:40
issues?
4:42
Yes.
4:42
Absolutely.
4:44
When caught early,
4:46
breast cancer has a 99%
4:48
survival rate. The customer if a patient is
4:51
looking at kind of a relatively minor surgery,
4:54
a lumpectomy,
4:55
maybe a little bit of radiation,
4:57
versus everything I went through. When caught late,
5:00
like at stage 3, you have an 80%
5:03
survival rate. And when caught at stage 4,
5:06
you have a 30%
5:08
survival rate. So there is a massive
5:11
value proposition in catching this early, I mean,
5:14
patients can live.
5:15
So as I reflected on my experience, there
5:18
were 3 gaps that I really wanted to
5:21
tackle to help drive early detection.
5:24
And by the way, when you find cancer
5:26
early at stage 1 versus stage 4, there
5:28
is a 350%
5:31
cost difference.
5:33
So there's also a significant value prop for
5:35
our client.
5:36
So the first the first gap we wanna
5:38
tackle
5:39
was you could've heard this in the story
5:41
probably, but there's a massive lack of public
5:44
awareness about around breast health.
5:47
So
5:48
1 in 8 women will get breast cancer
5:51
and 85%
5:53
have no family and no genetic history.
5:56
That stat is not out there. Most women
5:59
think tune out. I don't have to worry
6:01
about this. I don't have it in my
6:02
family. I don't have to I don't have
6:05
the gene.
6:06
But every woman needs to tune in, and
6:09
this is why getting your mammogram
6:11
and continuing to get the mammogram
6:13
are so important. So that simple stat is
6:16
just critical to help raise public awareness.
6:19
As women, we're taught that there's one side
6:22
of breast cancer, that it's a bump on
6:23
your breast. But actually, there's
6:26
one side of breast cancer and the bump
6:28
can be anywhere below your collarbone.
6:31
And so at Cigna, we really wanna change
6:34
this to help women understand the importance of
6:37
getting their mammogram and of this breast health.
6:40
So we actually launched a few initiatives here,
6:41
Jacob. Some are small, some are bigger. So
6:44
in October,
6:46
this year, in light of breast cancer awareness
6:48
month, we put a a cute little bra
6:50
image with the message get your mammogram
6:53
on the inside of PillCap.
6:55
So every woman receiving a script from our
6:57
select facility who is over 40 received this
7:00
cute little mammogram.
7:02
In October and this was available to all
7:04
clients across the board at no cost. Also,
7:06
in October, we launched a text messaging campaign
7:10
targeting women over 40 who had not yet
7:12
gotten their mammogram.
7:13
This was done in partnership with our Evernorth
7:16
partners.
7:17
And lastly,
7:19
we launched this October across the board available
7:21
at no cost to all clients, a partnership
7:24
with a company called Know Your Lemons.
7:27
Know Your Lemons offers an award winning digital
7:30
experience
7:31
and educates patients on breath breast health, such
7:34
as the twelve signs of breast cancer and
7:37
that a lump can be anywhere below your
7:38
collarbone,
7:39
stuff that you don't hear anywhere else.
7:42
And what's cool about it is they use
7:44
lemon instead of breath. A lot of cultures
7:47
or individuals
7:49
don't feel comfortable looking or talking about breath.
7:52
And so the visual use of a lemon
7:54
is a way to help kind of break
7:56
through those barriers and still provide education.
7:59
And their visuals, if you go online and
8:01
check them out, they're just captivating.
8:03
And it's not just for women. So for
8:05
men, it's gonna teach them what to look
8:07
for. It's gonna teach them how to have
8:09
conversations with their wives, their mothers, their daughters
8:12
about the importance of breast health. And so,
8:15
again, when caught early, breast cancer has a
8:18
99%
8:19
survival rate. All of this matters.
8:21
And,
8:22
know your lemons has some pretty compelling results.
8:25
So
8:26
when they found in their study, the customers
8:28
who kind of go through the know your
8:30
lemons experience, they have a 24%
8:33
increase in mammogram
8:35
and a 34
8:36
percent reduction in stage 4 diagnosis.
8:39
And so we're also launching so that's a
8:42
free version,
8:43
but we have a at work know your
8:45
lemon solution. We're also launching 1 125
8:48
that clients can buy up at a minimal
8:50
cost, and that's for clients who really wanna
8:52
lean in. If you want client specific reporting,
8:55
gamification
8:56
to help encourage more engagement on this app,
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That's what it does. It also provides every
9:02
single breast cancer diagnosed
9:05
customer with a box
9:07
called the dandelion box.
9:09
That box includes messages of hope. It teaches
9:12
them kind of how to get through with
9:13
tips and tricks. It explains the highly complex
9:16
landscape of chemotherapies
9:18
and lab results, etcetera, in easy to understand
9:20
ways.
9:21
So, again, the the first kind of that
9:24
was a lot, but all of these breast
9:26
health awareness programs
9:28
are really focused on driving early detection,
9:31
saving lives,
9:33
and lowering cost. I said that that there
9:35
were kind of 3, and so that was
9:37
one big big area we tackled pretty aggressively
9:40
here around breast health. But the second area
9:44
was
9:45
it's great to provide awareness. We need to
9:47
do that. But there still exist some barriers
9:50
for why women were not getting their mammogram
9:53
or their preventive exam.
9:55
So one barrier we hope to tackle here
9:57
is financial.
9:58
So come 1126,
10:00
we're launching a new premier oncology benefit
10:03
where
10:04
if you need to get a breath
10:07
a a mammogram,
10:08
a colonoscopy,
10:09
maybe an MRI or an ultrasound because you
10:12
have dense breasts, maybe you need a mammogram
10:14
but you're not 40 or 30 or 35,
10:17
you know,
10:18
patients are getting cancer younger and younger, specifically
10:21
breast and colon cancer.
10:23
If you have a diagnostic and clinical reason
10:26
for needing to get these exams despite the
10:28
age,
10:29
this benefit will cover you with a $0
10:32
cost there.
10:33
So we're we're really excited about this benefit,
10:36
again, targeted at removing any financial barrier for
10:39
the customer.
10:41
We also understand
10:42
another barrier
10:43
is scheduling,
10:44
as simple as scheduling.
10:46
So we're launching a solution 1 125 of
10:49
this year just in a few months. It's
10:50
called our preventative care outreach model.
10:53
And this is going to if they buy
10:55
up, it is going to proactively call targeted
10:58
members
10:59
reminding them to get their mammogram.
11:01
It tells them why it's so important, but
11:04
it will help them get it scheduled, which
11:07
is we understand a significant barrier.
11:10
And
11:11
lastly, you know, we we can't stop we
11:13
at Cigna, we can't stop women from getting
11:16
diagnosed with breast cancer or any type of
11:18
cancer. But we can and what you hear
11:21
from me is we're encouraging and hoping to
11:23
catch it early.
11:25
But if it is caught late, like in
11:27
my experience,
11:29
and one of the things I learned is
11:31
that what was most helpful
11:33
was when I was getting breast cancer specific
11:36
guidance
11:37
from my oncology nurse advocate at Cigna.
11:41
Because each cancer diagnosis
11:43
is unique.
11:44
It comes with their own drugs, their own
11:46
side effects, their different tips and tricks to
11:49
manage the side effects, there's different challenges and
11:52
resources
11:53
available.
11:54
And so one of the shifts
11:56
we've made at Cigna is we understand
11:59
a one size fits all approach for oncology
12:02
will not work.
12:04
Instead,
12:05
we're taking a differentiated
12:07
approach.
12:08
So we are connecting
12:10
customers with personal oncology nurse advocates
12:14
who are highly trained and qualified, not just
12:17
in oncology,
12:18
but they're offering condition specific tips, for example,
12:21
in breast cancer.
12:23
So here's some of the kind of tips
12:24
and tricks they're gonna share with you, Jacob.
12:27
When you're starting chemo,
12:29
the last thing on your mind or a
12:30
patient's mind is their eyelashes and their eyebrows.
12:33
Right? Like, they feel like they're dying. And
12:35
yet, getting some advice upfront before you start
12:39
chemo to say, hey. Consider
12:41
getting your eyebrows tattooed because you're gonna look
12:44
like an eye you know, you're gonna look
12:46
like a cancer patient not because you don't
12:47
have hair, but because you have no eyebrows
12:49
and eyelashes.
12:50
So consider getting your eyebrows microbladed
12:53
to tattoo that lasts 2 years. It's just
12:55
a little tip that we share with patients.
12:58
We also share if you're being treated with
13:00
adreanmicin,
13:01
that's on ice while you're receiving that infusion
13:04
for 20 minutes because that can prevent these
13:07
awful mouth sores.
13:08
If you're getting treated for capsule infusions, it's
13:11
about an hour long, consider wearing you can
13:14
buy them off Amazon,
13:15
ice mittens and booties.
13:18
Doing this will help reduce and minimize the
13:20
risk of developing neuropathy in your hands and
13:22
feet, and that's for life.
13:25
And so and they also understand Cigna's wig
13:28
benefit and local resources for free bit wig,
13:31
helping connect women
13:33
through these resources to help them feel confident.
13:36
And so this targeted condition support is unique
13:38
in the health care industry,
13:40
and this approach, you know, it provides holistic
13:42
assistance to really address the customer's
13:45
financial, medical, pharmaceutical, behavioral health needs
13:49
throughout their entire journey.
13:51
So as you just detailed, Margo, there is
13:53
so much amazing work going on across the
13:56
Cigna enterprise in terms of being aware of
13:59
the signs and symptoms of breast cancer and
14:01
then being proactive
14:03
about
14:03
breast
14:04
health. Any other,
14:06
innovations
14:07
or approaches,
14:09
from Cigna that you'd like to share about
14:11
in terms of advancing support,
14:13
for for breast cancer services, Margo?
14:17
Yeah. So
14:19
we've talked a lot about the programs that
14:21
Cigna is due to support the customer and
14:23
help us find it early, but we also
14:26
understand for clients, oncology is still a major
14:28
cost. In fact, when I look at our
14:31
total spend across Cigna's entire book by condition,
14:34
oncology is often the number 1 or number
14:37
2 cost driver across all conditions.
14:40
And what's interesting when you look at total
14:43
oncology cost a little bit deeper, the number
14:45
one driver of total oncology cost are medical
14:48
specialty drugs, and they drive 35%
14:51
of total cost. And so Cigna has an
14:53
industry leading benefit in network to manage these
14:56
costs called possible specialty.
14:58
And clients can save 15%
15:00
off their medical specialty drugs then. This is
15:03
a significant
15:04
program
15:05
to move the needle in managing the cost.
15:08
From the customer lens,
15:10
customers are often redirected
15:12
to their home. So they're giving the option
15:14
of instead of receiving this infusion in a
15:17
high cost hospital setting,
15:19
you could instead not have to go anywhere
15:21
and receive this infusion in the comfort and
15:23
convenience of your own home. And in fact,
15:25
50% of the time when we make these
15:28
calls, customers elect to do that.
15:31
And so we're launching a lot in 2024
15:33
and 25,
15:35
but we're not done. I mean, oncology, it
15:37
remains a top priority,
15:39
and I'm so grateful
15:41
I can use my experience to help others.
15:44
And that the Cigna enterprise has really embraced
15:47
the advocacy
15:48
of survivor
15:49
to drive change.
15:52
Absolutely. Well, it sounds like a lot of
15:53
amazing things on the horizon, Margo.
15:55
Before we go, you have a lot of
15:57
other health plan leaders listening in from all
16:00
over the country.
16:01
Any final thoughts or bits of advice you'd
16:03
like to share with them in terms of,
16:06
helping better better manage their their members' breast
16:09
health and and catching these issues early on.
16:14
Yeah. The one thing we didn't talk about
16:16
it, that it's almost the step one and
16:18
gets often overlooked, Jacob, is when you are
16:22
diagnosed with cancer, but you feel like you're
16:24
dying. Literally, when you walk out the door
16:26
of that doctor's office or you hang up
16:27
the phone, you feel like you're dying. It's
16:30
very difficult to comprehend basic information.
16:33
You need significant behavioral health. And that's truly
16:36
kind of the step one. In fact, many
16:38
cancer patients as I talked as I connected
16:41
with cancer patients in my journey, they cited
16:44
the hardest part
16:46
was that first part of moving from diagnosis
16:49
to before starting treatment. And so Cigna offers
16:52
247 behavioral health support, the program called confide,
16:56
and it connects a customer to a licensed
16:59
telephonic clinician.
17:01
And this was one of the first calls
17:03
I made.
17:04
And this period,
17:06
it's a massive mental health challenge.
17:08
People cancer patients are haunted by the fact
17:11
that the cancer is spreading. It's here. It's
17:13
here. And that may very well manifest in
17:16
unnecessary
17:17
ER visits or additional high cost unnecessary
17:20
imaging.
17:22
And so being able to support these patients
17:24
from a behavioral health standpoint immediately
17:27
to manage this massive anxiety,
17:29
maybe sleeping challenges, maybe depression
17:33
can also significantly
17:34
help, manage costs and avoid unnecessary
17:37
medical treatment.
17:39
And so,
17:40
Cigna doesn't just offer and connect oncology patients
17:44
with support immediately,
17:45
but they can connect oncology patients with
17:48
oncology
17:49
specific
17:50
behavioral therapists
17:51
who understand
17:53
what it feels like to feel like you're
17:55
dying and facing a potentially
17:58
years long treatment plan
18:00
and
18:01
the fear of cancer coming back for life.
18:04
And this is really unique in the industry,
18:06
offering oncology specific behavioral support that we feel
18:10
it can make all the difference.
18:12
Fantastic. Well, Margo, I thank you so much
18:16
for sharing about your experience and your journey
18:19
with us and our listeners, and thank you
18:21
for sharing your insights on on how our
18:23
listeners can can turn your experience into actionable
18:28
actions
18:29
for for their members. We we really truly
18:31
appreciate it.
18:32
Thank you again for having me, Jacob.
18:35
If you'd like to listen to more podcasts
18:37
from Becker's Health Care, you can visit beckers
18:39
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