The Exec: How Steakhouses and Oil Mining Helped Shape Evernorth's Joan Harvey

The healthcare industry veteran reveals Evernorth's top three priorities and how her unique experiences inform her leadership.

Harvey's focus? Service, community, and whole health—lessons she learned from an early age.

Joan Harvey's leadership stretches forward and back. President of Care Solutions for Evernorth Health Services, she comes from a long line of pioneers and stands ready to support the next generations.

With HealthLeaders, Harvey shares Evernorth's unconventional collaboration tactics. She also explains how her multi-entrepreneurial family and 20-plus-year career in healthcare helped her understand community networks and the people who rely on them.

Health services: Translating point solutions to value

We started with the basics: How does Evernorth define a health services organization?

"Our definition would be, how do we create an integrated, seamless solution for our customer so they understand how the different services work together for their specific journey? That customer includes that traditional healthcare consumer, employers, and other health plans."

For Evernorth—the health services division of The Cigna Group, created after its merger with pharmacy benefit manager Express Scripts—integration means putting pharmacy at the front end of managing chronic illness. And asking the right questions.

"How do I get access to care? How do I understand my condition? How do I work with providers from a holistic approach?" poses Harvey. The answers include proactivity, client needs clarity, and value delivery.

"In our fragmented world, you can have lots of point solutions. It's very difficult for a client to understand the overall value."

Evernorth today: "We really do have a philosophy and an open approach to partnering"

"What we want to get at, in an integrated fashion," says Harvey, "is to try to solve some of the biggest challenges in healthcare."

Here, Harvey details Evernorth's assets, including: pharmacy care solutions, analytics and insights, benefit management, and care services. The company seeks to "bring them together to predict, prevent, and support complex treatments while making access to care easier."

Harvey adds: "At the highest level, we really do have an open approach to partnership. It allows us to bring together the best minds to accelerate innovation."

These partnerships include Kaiser Permanente and Oscar Health—payer collaborators that historically were strictly competitors. Is there a degree of difference in how Evernorth navigates these new relationships? Harvey says yes.

"To solve the big problems in healthcare, we have to work together. Large organizations are starting to think about how we align our knowledge, our assets, and our understanding of consumers to solve not only fragmentation but access."

Evernorth's big three

Harvey gives the impression of a team that has its eyes on the same prize.

'We look at what is really front and center for our customers, our employer health plan clients and our government support areas," she says.

Evernorth's three front and centers are:

1. Accessible, affordable high-quality care;
    
2. How that care functions in an environment of fragmentation; and
    
3. How outpatient mental health can yield overall savings

Take the latter, mental health. A 2022 Evernorth study of 200,000 customers published in JAMA Network Open found that even a few routine outpatient behavioral health sessions can impact total cost of care.

Patients with newly diagnosed mental health and substance use disorders who completed at least one outpatient visit saved up to $2,565 in medical and pharmacy savings in the 15 months after diagnosis (e.g., via preventable inpatient stays and ER visits). Results continued 27 months post diagnosis with savings up to $3,321 compared to those without treatment.

An Evernorth spokesperson notes that this is a great example of how the health services company links a specific high-cost condition to a seamless, connected solution across the entire spectrum of care.

Family history part I: Colorado steakhouses and OPEC

"My father was a restauranteur, and I grew up working in his restaurants," shares Harvey.

"He had quite a command and was also very, very involved in the community. Understanding what kind of experience customers wanted was one of the biggest lessons I learned from him."

She adds: "In healthcare, people are the service. Every day, our clinicians are executing and delivering programs that are helping millions of people live better lives. If we can create a better environment where people understand their network, their benefits, then we can ensure that they are maximizing the financial opportunity to get access to care."

Harvey's lessons come from a unique corner of America and at a very specific point in time.

"We were in the western part of Colorado in the 80s—the OPEC, when Exxon brought in tens of thousands of people and created these mini cities around Grand Junction to build the first phase of oil shale extraction [fracking]. And so, my father built up all different kinds of restaurants."

It didn't last. Exxon abandoned its Colony oil shale project in 1982, stating it could not "prudently continue the Colony project alone."

"Within six months, all of those people left," says Harvey. "The infrastructure that was there to support them dried up and a lot of people went bankrupt."

But not Harvey's father, who had no intention of continuing alone either. He pivoted with his community.

"Because he had spent so much time understanding the community and supporting the businesses there, we were able to shift the business and say, 'Okay, we're not going to be serving executives anymore. We're going to focus on what the people here need and what we can provide.'"

Family history part II: Heart surgery and mental health

"The big lesson for me," says Harvey, "was on the dynamics of economics and the outside world: how you can be resourceful to support teams and partners inside your community, how you can do good by them as you adjust your business."

And her family's entrepreneurial lessons weren't limited to restaurants.

"I grew up in a very medical family. My grandfather and grandmother were big in the founding of open-heart surgery and in mental health," says Harvey. She's referring to Dr. Henry Swan, who pioneered heart surgery using hypothermia—an innovation that expanded the types of cardiac procedures that are now available. And to Mary Fletcher Gaylord, a mental health advocate at the local, state and national level, dating back to the 1950s.

"I have been into whole-person health my entire life. You have to bring the mind and body together," says Harvey, adding: "So in terms of how to run a business, I think about communities. I knew I didn't want to be a doctor but I really wanted to give back."

Like her father. Like her grandparents.

"Your job is to pay it forward—to do something better and make it a better system. My grandparents did that and that passion has been a driver for me since I first started in healthcare."