Such risks and uncertainties include, but are not limited to: our ability to achieve our financial, strategic and operational plans or initiatives; our ability to predict and manage medical costs and price effectively and develop and maintain good relationships with physicians, hospitals and other health care providers; the impact of modifications to our operations and processes; our ability to identify potential strategic acquisitions or transactions and realize the expected benefits of such transactions, including with respect to the Merger; the
substantial level of government regulation over our business and the potential
effects of new laws or regulations or changes in existing laws or regulations; the
outcome of litigation, regulatory audits, investigations, actions and / or guaranty fund assessments; uncertainties surrounding participation in government - sponsored programs such as Medicare; the effectiveness and security of our information technology and other business systems; unfavorable industry, economic or political conditions, including foreign currency movements; acts of war, terrorism, natural disasters or pandemics; our ability to obtain shareholder or regulatory approvals required for the Merger or the requirement to accept conditions that could reduce the anticipated benefits of the Merger as a condition to obtaining regulatory approvals; a longer time than anticipated to consummate the proposed Merger; problems regarding the successful integration of the businesses of Express Scripts and Cigna; unexpected costs regarding the proposed Merger; diversion of management's attention from ongoing business operations and opportunities during the pendency of the Merger; potential litigation associated with the proposed Merger; the ability to retain key personnel; the availability of financing, including relating to the proposed Merger;
effects on the businesses as a result of uncertainty surrounding the proposed Merger; as well as more specific risks and uncertainties discussed in our most recent report
on Form 10 - K and subsequent reports
on Forms 10 - Q and 8 - K available
on the Investor Relations section of www.cigna.com as well as
on Express Scripts» most recent report
on Form 10 - K and subsequent reports
on Forms 10 - Q and 8 - K available
on the Investor Relations section of www.express-scripts.com.
For example, the Gates Foundation's small school reforms were widely panned as a flop in early reviews relying
on student test scores, but a number of later rigorous studies showed (sometimes
substantial) positive
effects on outcomes such as graduation and college enrollment.
These findings extend the
substantial body of behavioral data demonstrating the deleterious
effects of poverty
on child developmental
outcomes into the neurodevelopmental domain and are consistent with prior results.8, 9 Furthermore, these study findings extend the available structural neuroimaging data in children exposed to poverty by informing the mechanism of the
effects of poverty
on hippocampal volumes.