Intrapreneurship at Cigna: CAM Coverage Opportunity

It is important to note, from the outset, that intrapreneurs are instrumental to the progress of any enterprise — particularly because they tend to be action-oriented, proactive, and motivated. In essence, there is no single standard definition of intrapreneurship, and various definitions have been proposed over time. In the words of Gifford Pinchot III (as cited in Daykin, 2019), "intrapreneurs are employees who do for corporate innovation what an entrepreneur does for his or her start-up." This is the definition adopted throughout this paper. Playing this intrapreneurial role, the discussion below assesses the various opportunities that could be of benefit to Cigna. Following the identification of one specific opportunity, its potential impact will be evaluated with regard to the benefits it may offer Cigna, as well as the resources and level of effort required to pursue it.

To a large extent, Cigna has an expansive network that smaller competitors cannot easily replicate. This network provides the company with a meaningful cost advantage. In addition, the company has built a comprehensive offerings catalogue and has positioned itself as a one-stop shop for a wide range of insurance programs and plans. These represent some of Cigna's key strengths.

The company, however, faces a significant threat to its continued success. Although Cigna's market presence is largely enviable, it is not unassailable. As Vourman et al. (2013) note, Cigna faces stiff competition from HMOs, PPOs, third-party administrators, and other large players. It therefore follows that the company must innovate if it is to remain relevant going forward. By doing so, Cigna would be well-positioned to leverage the strengths highlighted above — namely, its experience managing a comprehensive catalogue of insurance plans and programs, as well as its expansive provider network.

According to Prindle (2018), "many patients want alternative health care, but getting insurance coverage can be tough." As that author further notes, complementary and alternative medicine (CAM) continues to grow in popularity. In basic terms, CAM may be described as any healthcare treatment or practice considered non-conventional and not part of Western traditional medicine (Ruggie, 2004). A wide range of CAM services are offered across the country. Some of the more common ones include, but are not limited to, chiropractic care, acupuncture, massage therapy, naturopathy, and homeopathy. Not all of these CAM services fall outside of existing insurance coverage; according to Prindle (2018), a number of insurance companies already cover chiropractic care and acupuncture.

Cigna should pioneer the coverage of additional CAM services. This is especially warranted given that available data clearly indicates that more and more Americans are becoming interested in complementary and alternative medicine. According to a survey by Pew Research Center, "about half of Americans report having tried some form of alternative medicine, such as herbal remedies, acupuncture, chiropractic treatment or energy therapies, at some point during their lifetime" (Pew Research Center, 2017). This represents a substantial market that Cigna should seek to serve.

Relevance of Cigna's Expansive Network

Cigna already has an expansive network that includes over 700 accountable care programs, over 500 hospitals, and over 175,000 mental and behavioral healthcare programs (Cigna, 2020). If the company were to roll out coverage for CAM services, it would be able to reach millions of customers spread across the nation. That broad customer base would be instrumental in risk pooling — especially given that this is essentially a new frontier. Risk pooling is one of the most important concepts in insurance. As Ruggie (2004) explains, "pooling risks together allows the higher costs of the less healthy to be offset by the relatively lower costs of the healthy, either in a plan overall or within a premium rating category" (p. 79). In this case, millions of customers contributing to a common pool would enable the even spreading of risks — specifically those arising from expensive CAM claims — among contributors.

Relevance of Cigna's Comprehensive Offerings

It should also be noted that Cigna already maintains a large catalogue of offerings and is skilled in managing diverse programs and policies. This diversity of plans effectively makes Cigna a one-stop shop for insurance and healthcare coverage. This is a capability the company should leverage as it seeks to capitalize on the CAM opportunity identified in this paper.

Viability

As noted earlier, roughly half of all Americans have tried some type of complementary or alternative medicine. Further, as a Pew Research Center survey indicates, "about a fifth of Americans say they have tried alternative medicine instead of conventional medicine; and roughly three-in-ten adults have tried alternative medicine in conjunction with conventional medical treatment" (Pew Research Center, 2017). The viability of the proposed initiative is therefore not in question.