Ten thousand people are aging into Medicare every day, and many of them are dealing with chronic conditions. To serve them best, health care has to evolve away from fee-for-service transactions and toward holistic, integrated, value-based care, Humana leaders say in a new video.
And that care has to extend beyond the doctor’s office, taking into account a person’s community and the many social determinants of health.
“If we are going to actually improve the health of these elderly patients, who will be us in not too distant future, looking at outcomes and being paid based on quality is something that we should all be motivated to do,” said Dr. Roy Beveridge, Humana’s Chief Medical Officer.
According to the Centers for Disease Control and Prevention, chronic conditions cause “7 of 10 deaths each year” and account for “86% of our nation’s health care costs.”
Addressing that will require a more integrated approach and more high-quality engagement between physicians and patients.
“I lost my father when I was young because he had a heart attack and previous to that, he had a stroke… and he didn’t know how to navigate the health care system,” Said Dr. Jimmy Fernandez, Chief Medical Officer, MCCI. “We thought by him going to the emergency room – him getting the care, he’d get the resources and help he needed and truth be told, it was one piece of the puzzle. He didn’t follow up with anyone, and in a short period of time, he died. I’m here to prevent that from happening to my patients.”
Focusing on value, rather than tracking only services rendered, can go a long way.
“Here at Humana we’re making really great progress on our value-based work,” said Mike Funk, Vice President in Humana’s Provider Development Center of Excellence. Results for 2015 “showed a 19% improvement in our quality…and a 20% overall improvement in cost compared to traditional Medicare.”