Accounting Manager – Senior Advisor

Cigna (CI) has a 2026 growth story that looks bigger than medical costs. Why Cigna's thesis now runs through Evernorth as much as insurance. The usual shorthand on The Cigna Group is to treat it as an insurer whose stock lives and dies on medical-cost trends. That misses where most of the scale sits. In the first quarter of 2026, Cigna generated $68.5 billion of total revenue, and Evernorth Health Services alone produced $58.4 billion of adjusted revenue, compared with $11.5 billion for Cigna Healthcare adjusted revenue (The Cigna Group Q1 2026 release). Evernorth combines pharmacy benefit services with specialty and care services, giving Cigna an earnings base tied to drug mix, specialty distribution, and care delivery rather than only to insurance underwriting. That pattern was also visible in full-year 2025. Total revenue rose 11% to $274.9 billion, driven primarily by Evernorth, while adjusted income from operations increased 4% to $8.0 billion, or $29.84 per share (The Cigna Group FY2025 release). The long-run case increasingly depends on whether Evernorth can keep compounding through specialty volume and biosimilar adoption. How specialty mix and pricing discipline are shaping 2026 earnings. The first quarter shows why this is more than a simple membership story. Evernorth's adjusted revenue increased 9% year over year to $58.4 billion, while pre-tax adjusted income from operations increased 2% to $1.47 billion (The Cigna Group Q1 2026 release). The internal mix shift is the real story. Pharmacy Benefit Services revenue rose 11% to $33.0 billion, but pre-tax income fell 28% to $394 million because of expected lower contributions from large client relationships. Specialty and Care Services offset that: adjusted revenue rose 6% to $25.4 billion and pre-tax income climbed 20% to $1.07 billion, helped by specialty growth and higher generic and biosimilar adoption (The Cigna Group Q1 2026 release). Cigna Healthcare also gave the company a cleaner setup than the market often assumes. First-quarter 2026 adjusted revenue declined 21% to $11.5 billion, mainly because the Medicare businesses were sold to HCSC in March 2025, but adjusted income from operations before tax still increased 18% to $1.51 billion. The Cigna Healthcare medical care ratio improved to 79.8% from 82.2% a year earlier, and the company said underlying revenue excluding the HCSC transaction rose 8% because pricing increased to cover expected medical costs (The Cigna Group Q1 2026 release). That is a useful signal: Cigna is showing it can shrink lower-priority exposure, reprice commercial risk, and still improve profitability. Why the balance sheet and buybacks still matter to the CI story. CI is also not just a medical-cost trade because management still has capital allocation flexibility. Cigna ended March 31, 2026 with $7.0 billion of cash and cash equivalents, according to the 10-Q, and its debt-to-capitalization ratio improved to 42.3% from 43.0% at year-end 2025 (Cigna Q1 2026 10-Q). Capital return is already part of the earnings model. In full-year 2025, Cigna repurchased 11.9 million shares for about $3.6 billion, and it raised the quarterly dividend to $1.56 per share in February 2026 from $1.51 in 2025 (The Cigna Group FY2025 release). The first-quarter 2026 outlook also explicitly included the effect of expected future share repurchases, meaning buybacks are embedded in how management frames per-share earnings power (The Cigna Group Q1 2026 release). That matters after the Medicare divestiture. Cigna has already shown willingness to reshape the portfolio instead of defending every line of business. A company with a large services platform, steadier commercial pricing, and ongoing buybacks can still compound even if it no longer looks like a traditional membership-growth story. What investors should watch next in the Cigna Healthcare and Evernorth segments. The next watchpoint is whether Evernorth keeps shifting toward the parts of the business that carry better strategic value. Specialty and Care Services delivered stronger income growth than Pharmacy Benefit Services in the first quarter, so investors should watch whether biosimilar adoption and specialty volume keep offsetting pressure in large client relationships. The second watchpoint is whether Cigna Healthcare can preserve its pricing discipline without giving back the margin gains. The first-quarter medical care ratio of 79.8% was better than a year ago, but the company's full-year 2026 outlook still calls for a Cigna Healthcare medical care ratio of 83.7% to 84.7% (The Cigna Group Q1 2026 release). That implies some normalization ahead. Finally, investors should watch whether customer relationships stabilize after recent transitions. Pharmacy customers were 121.0 million at March 31, 2026, down from 123.6 million at year-end 2025, while total customer relationships fell to 185.5 million from 188.4 million (The Cigna Group Q1 2026 release). If specialty economics and commercial margins keep improving, CI can work even with modest churn. Key signals for investors. * Evernorth generated $58.4 billion of first-quarter 2026 adjusted revenue, far outweighing Cigna Healthcare's $11.5 billion, which reinforces that CI is a health-services platform as much as an insurer (The Cigna Group Q1 2026 release). * Specialty and Care Services pre-tax income rose 20% in the first quarter of 2026 even as Pharmacy Benefit Services income fell 28%, showing where the earnings mix is improving (The Cigna Group Q1 2026 release). * Cigna Healthcare's medical care ratio improved to 79.8% in Q1 2026 from 82.2% a year earlier, suggesting pricing and portfolio shaping are helping offset insurance-cost noise (The Cigna Group Q1 2026 release). * Cigna ended Q1 2026 with $7.0 billion in cash and a 42.3% debt-to-capitalization ratio, while 2025 buybacks totaled about $3.6 billion, supporting continued per-share earnings growth (Cigna Q1 2026 10-Q; The Cigna Group FY2025 release). Sources. * https://www.sec.gov/Archives/edgar/data/1739940/000114036126017971/ef20071317_ex99-1.htm * https://www.sec.gov/Archives/edgar/data/1739940/000173994026000043/ci-20260331.htm * https://www.sec.gov/Archives/edgar/data/1739940/000114036126003768/ef20064751_ex99-1.htm * https://www.sec.gov/Archives/edgar/data/1739940/000173994026000006/ci-20251231.htm * https://investors.thecignagroup.com/overview/default.aspx * https://data.sec.gov/submissions/CIK0001739940.json

Midlands hospital system reaches agreement to be back in-network with large insurance provider. WEST COLUMBIA - After five months without a contract, one of the Midlands' largest healthcare providers is once again in-network for customers of a large health insurance company. Lexington Health, the local healthcare network anchored by a 607-bed hospital in West Columbia, announced via its website that it has reached a multi-year contract with Cigna. "As a result, Lexington Medical Center and our affiliated physician practices will be in network with Cigna starting July 1, 2026," the hospital system said. "If you had appointments or procedures cancelled due to the disruption in our network status, you can now reschedule with your doctor's office," Lexington Health added. "If you have any coverage or plan-specific questions, please contact Cigna at the phone number on the back of your insurance card. We appreciate your support of Lexington Medical Center and our network of care. Thank you for choosing us to care for you and your family." In a release, Lexington Health said that patients will receive notifications via MyChart and mailed letters, and patients who previously had procedures or appointments canceled due to being out-of-network with Cigna can contact their providers' office to reschedule. Lexington Health and Cigna reconnect. The hospital first announced that it would shift to being out-of-network for Cigna customers in early December. The change went into effect at the start of 2026. At the time, Lexington Health said it was not able to reach a "fair and sustainable agreement" despite "working in good faith." Cigna previously said Lexington Health was demanding double-digit rate hikes that would "make care unaffordable." "Reaching a fair and sustainable agreement requires time and continued dialogue," Lexington Health CFO Jeff Brillhart said in a release. "We are pleased to have this negotiation finalized, and most importantly, we sincerely thank our patients for their trust and understanding throughout this process." In absence of an agreement, Cigna customers faced significantly higher costs if they continued to utilize Lexington Health's services. Emergency care was still treated as in-network. Cigna is one of the largest health insurance providers in the country, with over 67,700 employees and 185 million customers worldwide, according to the company's website. "We are pleased to have reached agreement with Lexington Medical Center to bring them back into the Cigna network, restoring in-network access for the community we both serve," Cigna said in a provided statement. "Together, we will continue efforts to improve health and vitality for our customers and their families."

Eric Palmer joins AMN Healthcare board of directors. Healthcare staffing leader AMN Healthcare has appointed former Cigna Group executive Eric Palmer to its board of directors. The company announced the move on May 13, 2026. Palmer brings deep industry knowledge and decades of executive-level experience. His addition signals AMN Healthcare's focus on strengthening its strategic leadership. Who is Eric Palmer? Eric Palmer is a veteran healthcare executive with a career spanning more than 25 years. He built his professional foundation entirely at Cigna Group. During his long tenure, he rose through the ranks to hold some of the company's most senior positions. He departed Cigna in April 2025 after a distinguished run at the top of the organization. His key roles at Cigna. Palmer's career at Cigna was marked by significant leadership milestones. Most recently, he served as CEO of Evernorth Health Services, Cigna's health services segment. Before that, he held the role of Chief Financial Officer (CFO) for the broader Cigna organization. His time as CFO was particularly impactful. He played a central role in Cigna's landmark acquisition of pharmacy benefit manager Express Scripts. That deal reshaped Cigna's business model and expanded its footprint in the pharmacy and specialty health services space. Consequently, Palmer earned a reputation as a dealmaker and strategic thinker at the highest levels of corporate healthcare. Why AMN Healthcare chose Palmer. AMN Healthcare selected Palmer for his proven record across several critical areas. According to the company's May 13 news release, he brings a "strong track record of leading large-scale operations." Additionally, he has deep experience in driving strategic growth initiatives. Furthermore, he has successfully executed complex mergers, acquisitions, and divestitures throughout his career. A strong fit for the board. Palmer's background aligns closely with AMN Healthcare's current priorities. The company operates in a competitive and rapidly evolving healthcare staffing market. Therefore, board-level expertise in operations, finance, and M&A is especially valuable. His familiarity with the healthcare ecosystem also gives him a distinctive edge compared to generalist board candidates. What this means for AMN Healthcare. AMN Healthcare is navigating a dynamic period in the healthcare staffing industry. Workforce shortages continue to challenge hospitals and health systems across the country. Against this backdrop, strong governance and strategic leadership are more important than ever. Palmer's appointment directly addresses this need. His experience scaling complex organizations will support AMN Healthcare's long-term growth strategy. Moreover, his understanding of payer-provider dynamics adds a dimension of insight that the board previously lacked. As a result, AMN Healthcare is better positioned to respond to market shifts, regulatory changes, and staffing demand fluctuations. Leadership Perspective from the CEO. AMN Healthcare President and CEO Cary Grace welcomed the appointment enthusiastically. She highlighted several reasons the board selected Palmer. "Eric's extensive leadership experience, understanding of the healthcare ecosystem and alignment to our mission make him a valuable addition to our board," Grace said. She added that his ability to scale complex organizations and navigate dynamic market environments would strengthen governance and support AMN's long-term goals. Grace's remarks underscore that this is not simply a symbolic appointment. Rather, Palmer joins AMN Healthcare's board with a clear mandate to contribute meaningfully to its strategic direction. About AMN Healthcare. AMN Healthcare is one of the largest healthcare staffing and workforce solutions companies in the United States. The company serves hospitals, health systems, and other healthcare facilities nationwide. Its services include travel nurse staffing, physician staffing, allied health staffing, and workforce technology solutions. A growing governance focus. AMN Healthcare has consistently invested in building a diverse and experienced board. Each new member brings specific expertise relevant to the company's evolving needs. Palmer's addition continues this pattern. His finance, operations, and health services background complements the existing board's capabilities. Conclusion. Eric Palmer's appointment to AMN Healthcare's board of directors marks a notable move in healthcare executive leadership circles. His 25-plus-year career at Cigna, including roles as Evernorth CEO and Cigna CFO, gives him rare breadth and depth. AMN Healthcare gains a board member with proven skills in M&A, large-scale operations, and strategic growth. As the healthcare staffing industry faces ongoing workforce challenges, this appointment positions AMN Healthcare to navigate complexity with experienced guidance at the top.