David Cordani : Sure, Gary. A lot in there. Let me try to address the points, all important points, and I appreciate your question. First and foremost, to be clear, our strategy remains consistent. Our preferred approach on the core medical fulfillment of care is to partner and enable. I’ll come back to that. As we’ve discussed before, there are parts of the healthcare delivery or service fulfillment equation that we seek to own, and we’re very clear relative to that. Examples include virtual, behavioral, specialty pharmaceutical fulfillment and select aspects of home care, we deem them to be unique, highly differentiated and an ability to leverage over multiple geographies in an efficient way. Our notion of partnering continues through, we’ll call it, core value-based care, where today, about 75% of our MA customers have a value-based care relationship.
About 50% of our exchange customers have a value-based care relationship. And about 40% of our commercial employer business has a value-based care relationship. Now to the Village relationship. First and foremost, it’s also a clear depiction as we discussed at our Investor Day, that we see the healthcare delivery system community as an addressable market for us. We see it as an addressable market to bring additional services to help to extend their reach, their care coordination, curation of high-performing specialty networks and overall continuity of care, including digital aspects of the care equation. So the Village relationship, we see as an extension of partnering we see that payer agnostic orientation that you articulated as a positive because Evernorth serves a broad portfolio of clients including most of the large health plans in America today in some way, shape or form.
And we see the ability to grow collectively and collaboratively with Village as a positive, but through partnering set of relationships. So to reiterate, there are aspects that we’ll seek to own. We will continue to use our current process of incentive alignment and care coordination to extend our core value-based care offerings. And now with Evernorth, we will seek to deepen those services with select provider partners for the benefit of the totality of the panel, not just for the Cigna Healthcare lives that go through. However, there may be some unique programs that are designed from a Cigna Healthcare standpoint. So we see this as a great win-win and an additional growth opportunity for Evernorth. Gary, I hope that helps.
Operator: Our next question comes from Ms. Erin Wright with Morgan Stanley.
Erin Wright : You mentioned some of the headwinds and tailwinds for Evernorth into 2023. And obviously, there’s the Centene implementation cost. But you also mentioned some other strategic investments. And can you quantify those? Or what is that exactly? And in the back-end weighting across the segment, is that largely attributable to those associated costs? Or is that a little bit of the HUMIRA benefit has been or changeable comes available midyear?
Brian Evanko : Erin, it’s Brian. So as it relates to the headwinds and tailwinds you’re right to call out the strategic investments. So we continue to invest an outsized amount of money in areas such as our Evernorth Care services platform to enable things like VillageMD that David just discussed alongside our specialty pharmacy business, which continues to grow at very attractive rates. And so, that’s all been factored in alongside the Centene related implementation costs. But importantly, we have tailwinds that allow us to introduce our guide today with at least 4.5% income growth for the Evernorth segment, inclusive of those pressure points on the spending side. As it relates to the cadence of Evernorth earnings, you should think of the back half weighting that I referenced is primarily driven by the biosimilar ramp effect that I described, but not entirely, there’s also some effect of the cadence of operating expense spending over the course of the year that also impacts the timing.
But the biosimilar contributions, we do expect to be more back half weighted, which is a key driver of the difference in the cadence.
Operator: Our next question comes from Mr. Kevin Fischbeck with Bank of America.
