MDLive Inc.
2021
Why
Add virtual urgent, primary and behavioral care to Evernorth.
Impact
Gives Cigna and Evernorth clients a virtual care option.
Outcome
MDLive operates within Evernorth; the purchase price was not disclosed.
The Cigna Group
Managed Healthcare and Pharmacy Benefit ManagementFounded 1982- HQ today: Bloomfield, Connecticut
Reviewed by Swet Parvadiya
Company data updated: October 2026
Acquisitions
Cigna Acquisitions
3
Major Deals Covered
$70.8B
Disclosed Deal Value
What are Cigna's biggest acquisitions?
Cigna's largest disclosed acquisition here is Express Scripts Holding Company for $67B in 2018. This page covers 3 major deals from 2012 to 2021, each with its price where disclosed and the reason behind it.
- Major deals covered
- 3
- Largest deal
- Express Scripts Holding Company ($67B)
- First deal
- 2012
- Most recent
- 2021
| Company | Year | Price | Purpose |
|---|---|---|---|
| Express Scripts Holding Company | 2018 | $67.0B | Cigna bought Express Scripts to add pharmacy benefit management at scale after the failed Anthem merger and to combine medical and pharmacy data. |
| HealthSpring Inc. | 2012 | $3.8B | Entry into Medicare Advantage and Part D. |
| MDLive Inc. | 2021 | Undisclosed | Add virtual urgent, primary and behavioral care to Evernorth. |
- What companies has Cigna bought?
- Major acquisitions by Cigna documented here include Express Scripts Holding Company (2018), HealthSpring Inc. (2012) and MDLive Inc. (2021).
- What is Cigna's most recent acquisition?
- The most recent Cigna acquisition documented here is MDLive Inc., in 2021.
Express Scripts Holding Company
2018
$67.0B
Why
Cigna bought Express Scripts to add pharmacy benefit management at scale after the failed Anthem merger and to combine medical and pharmacy data.
Impact
Pharmacy services became the majority of Cigna's revenue, and revenue rose above $150 billion by 2020.
Outcome
Express Scripts anchors Evernorth Health Services and is one of the three largest U.S. PBMs.
HealthSpring Inc.
2012
$3.8B
Why
Entry into Medicare Advantage and Part D.
Impact
Made Cigna a Medicare Advantage insurer for more than a decade.
Outcome
Cigna sold its Medicare Advantage and Part D businesses, including the former HealthSpring operations, to Health Care Service Corporation in 2025.
The Cigna Group's Growth & Acquisition Strategy
Cigna's growth plan centers on Evernorth: winning PBM clients with the rebate-free and transparent pricing models, growing Accredo specialty pharmacy and biosimilar programs, and selling services such as EncircleRx for GLP-1 cost management and Embarc Benefit Protection for gene therapies to other health plans and employers. On the medical side, Cigna Healthcare targets employer growth in select markets, stop-loss and international health benefits. Capital deployment combines dividends and share buybacks with targeted deals rather than large insurance mergers.
How The Cigna Group Makes Money
Cigna makes money in two ways. Evernorth Health Services, the larger business by revenue, runs Express Scripts pharmacy benefit management, Accredo specialty pharmacy, home-delivery pharmacy, eviCore utilization management and MDLive virtual care; it earns dispensing margins, administrative and service fees, and purchasing economics on prescription drugs for health plans and employers. Cigna Healthcare sells employer and individual health coverage in the U.S. and internationally. Most of its U.S. medical customers are in self-funded (ASO) plans, where the employer pays claims and Cigna collects fees for networks, claims processing and care management, while insured plans earn premiums. In October 2025 Cigna announced a rebate-free Express Scripts model that shifts pharmacy economics toward upfront discounts and transparent fees.
Cigna Acquisitions FAQ
What was the landmark acquisition of Express Scripts in 2018 and how much did it cost?
In December 2018, Cigna completed the acquisition of pharmacy benefit management giant Express Scripts Holding Company for $67 billion ($54 billion in cash and stock plus $13 billion in assumed debt), creating an integrated healthcare and pharmacy services leader.
Why was the acquisition of eviCore healthcare in 2017 transformative?
In December 2017, Express Scripts acquired medical benefits management leader eviCore healthcare for $3.6 billion, adding clinical decision support, medical oncology management, and advanced radiology utilization review to the portfolio.
What was the acquisition of telehealth pioneer MDLive in 2021?
Evernorth acquired MDLive in 2021 to add virtual urgent, primary and behavioral care. Cigna did not disclose the price.
What was the acquisition of HealthSpring in 2012?
In January 2012, Cigna acquired Medicare Advantage insurer HealthSpring for $3.8 billion in cash, establishing a major presence in government Medicare Advantage before agreeing to divest the segment to HCSC in 2024 for $3.7 billion.
What was the acquisition of CuraScript and Accredo by Express Scripts?
Prior to its merger with Cigna, Express Scripts built the nation's premier specialty pharmacy pipeline by acquiring CuraScript in 2004 and merging with Medco Health Solutions in 2012 for $29.1 billion, creating Accredo Specialty Pharmacy.
What was the acquisition of Great-West Healthcare in 2008?
In April 2008, Cigna acquired Great-West Healthcare for $1.5 billion, adding 2.2 million commercial health members, expanding Cigna's presence among small and mid-sized employers, and adding 150,000 healthcare providers to its network.
What was the divestment of international life and accident businesses in 2022?
In July 2022, The Cigna Group completed the sale of its life, accident, and supplemental health insurance businesses in seven Asia-Pacific and European countries to Chubb for $5.4 billion in cash, returning proceeds via share buybacks.
Did Cigna buy Express Scripts?
Yes, after a massive, multi-billion-dollar merger attempt with Anthem was blocked by the US government on antitrust grounds, Cigna pivoted in 2018 and aggressively acquired Express Scripts for $54 billion.
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