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Meeting highlights:
- Cigna Healthcare Spain’s Priorities & Vision: Consolidating its position as a specialist and premium provider in the B2B corporate health insurance segment, double-digit growth above market trends, enhancing digital capabilities and differentiating as a real partner in health.
- Digital Transformation: Doctor Cigna is a personalized telemedicine platform that adapts to the customers' evolving needs and makes healthcare more accessible.
- Collaborations & Partnerships: MD Anderson Madrid for cancer awareness and workplace prevention. Legit.Health for AI-based skin cancer prevention via image recognition. Clinical History Project: participating in initiatives for shared patient medical records. Spanish HR Association (AEDRH): working with HR leaders to promote mental health and wellbeing at work.
- Spanish Market Outlook: Due to public system strain post-COVID, demand for private insurance is rising, yet tensions between low insurance premiums and rising medical costs threaten the system’s sustainability.
- Culture & Talent: Cigna Healthcare Spain tries to implement internally the same wellbeing strategies offered to clients and has a customer-centric approach.
- Reflection & Proudest Moments: Cigna Healthcare Spain is seen as a trusted health partner thanks to its people-first, service-driven culture.
EF: You have been with Cigna for over 18 years, including the last eight as CEO. What are your current priorities, and how do your initiatives in Spain align with the company’s global product transformation?
JJM: I began my career in finance and gradually embraced a broader role. Over the past eight years, we’ve positioned Cigna as a leader in corporate healthcare in Spain. Our goal is to be recognized as the premium provider and a specialist in the corporate segment across the Spanish peninsula. We aim for strong, double-digit growth, and over the past seven years, we’ve achieved an accumulated rate of approximately 12 to 15%, significantly outpacing the market average of 6 to 7%.
This growth is critical in a market defined by high volume and scale, as it strengthens our relationships with stakeholders and enables us to deliver high-quality services to clients and customers.
A central pillar of our strategy is enhancing our digital capabilities. We’re investing in tools to streamline interactions with clients, customers, medical providers, and brokers. Each year, we update our value proposition, expanding medical plan coverage and incorporating innovative techniques. We aim to differentiate ourselves not just through competitive insurance plans and a broad network, but by acting as a true partner to our clients.
In healthcare, our focus is on delivering the best solutions for our clients’ employees, from comprehensive plans to prevention programs and healthy lifestyle guidance. Our mission is to help organizations foster healthy, engaged, and productive workforces.
Another key priority is balancing rising medical costs with the need to provide effective, affordable care. Innovation moves quickly, and while it can be expensive, it’s essential to offer the right solutions at a fair price. Striking this balance isn’t easy, and delivering high-quality service demands appropriate investment.
In Europe, healthcare premiums are relatively low, even compared to regions like the Middle East or Asia. This makes it difficult to align the revenue we generate with the advanced solutions we aim to deliver.
EF: How has Cigna adapted to the changing realities of work and the evolving needs of employers?
JJM: We have enhanced our capabilities to provide improved and easier access to medical services for our customers. A key initiative is our telemedicine platform, Doctor Cigna, designed for corporations. According to Spanish law, companies with over 300 employees are required to have a doctor on-site. However, for smaller companies that do not have a doctor on staff, we offer the services of Doctor Cigna, who serves as their company physician. What sets Doctor Cigna apart from other global telemedicine platforms is its personalized approach; each client is assigned a doctor who is familiar with their medical history and needs.
We have developed digital capabilities in Cigna Spain to provide services to Spanish residents, offering policies that ensure fast and efficient administrative interactions.
EF: How will AI assist healthcare delivery from the insurers’ perspective? How is Cigna implementing solutions internally?
JJM: AI is the future, but implementing AI tools in healthcare is complex. At Cigna, we take things one step at a time.. We use AI to enhance efficiency and provide support to our operational teams, enabling them to work more effectively and add value to their tasks. We also utilize AI to automate tasks that employees previously handled. AI will significantly enhance efficiency and reduce the time spent on administrative tasks, while also assisting in medical functions such as prevention and diagnosis. Our current focus is on using it to enhance our processes and provide greater value to our workforce.
EF: How do you collaborate with institutions, companies, and providers to create value and increase awareness about prevention and healthier living?
JJM: Prevention is essential, as it can save both time and money in the future. We are actively engaged in preventive initiatives and collaborate with various stakeholders across the healthcare ecosystem. We participate in several partnerships that deliver prevention services. For example, we have an agreement with MD Anderson in Madrid, a leading authority in oncology, to work together on awareness and prevention initiatives. Last year, we launched the second edition of our guide to cancer in the workplace, which provides advice on preventing and minimizing habits that could lead to cancer.
We also collaborate with Legit. Health is an innovative company focused on skin cancer prevention. Their AI technology uses skin image recognition to analyze photos of a person’s skin. By uploading an image, the system can determine whether the issue is severe or non-severe. If necessary, it connects the patient with a doctor for further consultation.
Another partnership is with Fundación IDIS, where we work on innovative projects such as the Unique Clinical History. This initiative enables patients to carry a single, portable medical record across different healthcare providers and hospitals, avoiding the need to restart their medical history every time they change institutions. It’s an ambitious plan, but one we are committed to making a reality.
We are also part of AEDIPE (Spanish Association for People Management and Development), AEDRH (Spanish Association of Directors of Human Resources) or OBBIO (Organizational Well-being Observatory) to support employee well-being across Spain. We offer various programs focused on integral wellbeing, more specifically mental health, addressing stress and pressure in the workplace. These types of initiatives are already present in many global corporations and are designed to guide employees in managing these challenges effectively.
Research suggests that higher employee engagement leads to increased productivity. By fostering a greater sense of belonging, we help build a more positive work environment. Our role goes beyond simply providing medical assistance; we aim to be our clients’ best health partner in the Spanish market, constantly adding value to their organizations.
EF: How do you evaluate the main challenges and opportunities in the Spanish market, particularly regarding funding models and the sustainability of regulations for private insurance as it enters the market?
JJM: We are currently witnessing a significant shift in the corporate health plan landscape. Since the pandemic, many people have been seeking more effective healthcare options. In Spain, while public health offers universal coverage, people often prefer private health insurance because it provides access to specific hospitals, specialists, and facilities..
Post-pandemic, having good health coverage has become more important than ever, especially as the National Health Service faces increasing pressure, including long waiting lists. In some cases, people may wait three to six months for an appointment. As a result, we are seeing a growing number of individuals turning to private health insurance.
The Spanish health insurance market is clearly positioned for continued growth. Traditionally, doctors and hospitals were not highly remunerated. However, since the pandemic, demand and prices have increased in their favor. Compared to other countries, prices in Spain remain low, but we are now seeing a “perfect storm” of rising costs across doctors, hospitals, and other providers. This is leading to increasing premiums, which are necessary for the market to remain sustainable.
In Spain, civil servants were the only group that could not opt for private health coverage. They had previously been allowed to do so and often chose private insurance. But the premiums paid by the government were insufficient to cover actual medical costs. By the end of last year, the remaining three insurers informed the Spanish government that they would exit the agreement unless premiums were substantially increased.
After failed negotiations, civil servants were transferred to the public health system, sparking considerable backlash. Many had relied on private coverage for over 30 years. Following strikes and widespread demands, a new agreement was reached, but it came with a 40% increase in premiums, a sharp jump from the previous average of 3% to 5%. These higher premiums are now essential to cover rising medical costs.
Despite the increasing expense of innovative treatments, access is expanding, and more people are actively seeking these options. Spain’s public health system is still highly respected and home to top specialists. Today, many of those professionals have also transitioned to the private sector.
Currently, private health insurance penetration stands at around 25% nationally, with slightly higher levels—around 30%—in Madrid and Barcelona. The trend suggests that demand for private insurance will continue growing year after year.
EF: What makes Cigna special as an employer, and how does your model demonstrate care for employees within the company culture?
JJM: We provide our clients with a compelling value proposition, offering the highest quality care services, including prevention and wellness plans, and our company adheres to the same principles we promote to our clients.
We lead by example, and our core value is being customer-centric. Everyone in the company understands the importance of the customer in all processes, whether it's related to services, appointments, reimbursements, or addressing customer inquiries. This customer-centric approach and the emotional support we give our clients distinguish Cigna in the Spanish market. Our success in this area may be attributed to our relatively small size, especially when compared to most of our competitors. Being smaller allows us to offer a more personalized service and maintain a closer relationship with our clients. We assign a representative to each company to address any issues or questions that may arise. Our commitment to serving our clients is a key aspect of the Cigna culture, particularly in Spain, where we operate as a small business unit.
EF: Do you have a final message to share?
JJM: If I could choose anything in the world for my friends and family, something they would always have, I wouldn't select money or even happiness; I would choose health. This reflection highlights the importance of health.
Cigna is known in Spain for premium services and a strong network of specialists, but what truly sets us apart is how deeply we care for our clients. Our mission is to promote the health and vitality of those we serve, and over the past eight years, we've become a trusted partner in healthcare.
By putting patients and customers at the center of everything we do, we deliver meaningful results. Feedback from clients, providers, and stakeholders consistently shows that Cigna offers more than just great coverage; we offer a culture of care, reflected in the dedication of every employee. That’s what makes me most proud.
