Cigna Healthcare’s $54 billion acquisition of Express Scripts at the end of 2018 was completed at a truly miraculous rate, considering the two companies employed considerably more than 30,000 employees each. The combining of one of the nation’s largest providers of health services with one of the three largest pharmacy benefit managers opened a monumental chapter for Cigna.
“Together, we are establishing a blueprint for personalized, whole-person healthcare, further enhancing our ability to put the customer at the center of all we do by creating a flexible, open, and connected model that improves affordability, choice, and predictability,” Cigna president and CEO David M. Cordani said in a statement. “By approaching each individual as a whole person—body and mind as one—we are empowering and supporting customers to take control of their total health and well-being.”
But the deal was just the beginning for Cigna Vice President and Chief Counsel of Litigation Viktoriya Torchinsky-Field, who joined Cigna in 2008. At that time, the company was on the cusp of its strategic shift to becoming a fully-fledged global health services company, and the world of healthcare has only continued to increase in complexity since. Throw in an industry-disrupting acquisition that fundamentally reshapes a health services provider, and it’s easy to see how the changes could be disorienting for teams and their members. But Torchinsky-Field sees it another way entirely.
The Puzzle Pieces
“There is tumult and uncertainty around healthcare from every single direction,” Torchinsky-Field says. “Imagine if you were handed a box of a thousand puzzle pieces and you’re told that it’s a Picasso painting. But you don’t know which one or which period. It’s not going to be straightforward, and it will most certainly be unconventional. They all have to fit together, with each piece in its place, with no pieces left over at the end. That’s our challenge.”
It’s that creative approach to not only the integration of a new partner but also the approach to healthcare at large that has made Torchinsky-Field’s thought leadership a priority in her role. “From partnering with our amazing government affairs team or our media and communications team, to working with our business lawyers who are plugged into the crucial details and our regulatory lawyers who are watching every state and all the federal government moves: it informs the outline of what I think the puzzle is and, frankly, is an exciting role for me,” she says.
Culture, Strategy, and a New Cigna
Keeping all of those parties aligned and in concert is an inherently tough issue to tackle, but it’s part of a broader initiative to align vision, strategy, and values. “If we all know what our strategy is, if our priorities are the same and we have shared values, I think the only outcome of putting those pieces together is that culture and strategy are holding hands.”
The acquisition of Express Scripts has been a success for Cigna, but integrating such a large organization hasn’t been without its challenges. “There are cultural differences that need to be addressed, and then there is the time it takes for stakeholders to get to know their new legal colleagues, who are in a supporting, but very important, role for them,” Torchinsky-Field says. “That takes effort from my team to make sure we gain the confidence of our new colleagues and, through this process, come to be perceived as a key business partner in all circumstances. It takes time for in-house litigation counsel to become part of the inner circle. That process is crucial. And it can be bumpy.”
Torchinsky-Field says she leads her team with a twofold philosophy that has taken time to develop and communicate effectively. “When the company is confronted with a problem, the litigation team comes in, with the initial goal of getting to the source of this dispute and figuring out how to address it, either through defensive or affirmative means, or both,” she explains.
“If we all know what our strategy is, if our priorities are the same and we have shared values, I think the only outcome of putting those pieces together is that culture and strategy are holding hands.”
“But there’s another goal that my team is entrusted with as I see it and direct it—to look for the root cause of a problem, figure out if there’s ongoing risk, and develop a plan to mitigate that going forward,” she adds.
Culturally, that may be a new, deeper charge for new members to the litigation team, the VP admits. “What we’re seeing now is that our high-impact and complex matters have evolved from a simple issue or two, to be dealt with efficiently, to requiring a 360-degree role in addressing a multifaceted problem, and we need to approach it as such.”
Cigna has emerged as a champion for its clients and customers in the COVID-19 health crisis. Torchinsky-Field’s “radical flexibility” approach to the sudden shift to work from home has enabled the team to get a head start on preparing for an unprecedented wave of added challenges. “Counterintuitively, it turns out that the pandemic has accelerated Cigna and Express Scripts’ integration and our coming together as one team. We ‘took off our team jerseys’ and got down to business together even as we all developed new remote working skills,” she says.
Thought Leadership When It’s Needed Most
The evolution of Torchinsky-Field’s leadership is rooted in twelve years of adapting to the increasingly large swings of the healthcare debate in America. The complexities and demands of the evolving healthcare system mandated a much more holistic response from her team.
“We could see a problem originate from a prelitigation demand or a lawsuit or complaint that’s filed in court,” she explains, “but it could also, and frequently does, evolve to include a consumer complaint, or an attorney general of a state opening an investigation, or a Department of Justice issuing a civil investigative demand. There are many, many more.
“Being strategic for my team means being able to anticipate and prepare for any or all of those levers being activated by external forces with respect to any particular problem that lands on our desk,” she continues. “Most of the time it doesn’t actually come to pass or most of these levers aren’t activated. But increasingly we’re seeing that they might be.”
It’s the legal leadership embodied by Torchinsky-Field that elevates the litigation role to one much more ingrained in Cigna’s holistic approach to healthcare. She isn’t certain exactly what the puzzle is going to look like yet, but she’s ensuring that every piece is accounted for—and ready to be placed.