caregivers

Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — The Human Problem With Health Technology — is reprinted below. To see all of his blog posts, click here.

One of my favorite activities is taking a bike ride. It’s a wonderful way to experience nature and challenge myself. How many miles did I ride? How long did it take? Did I do better than my last time?

Cycling is traditionally an individual sport, so I use a Garmin device to answer those questions. My Garmin device provides me with details, but it’s limited when it comes to seeing how I relate to others who also love cycling. For that, I use the app Strava.

Strava is a way for me and others to see how we measure up to one another. Strava is not a device, but it’s designed to create a community by connecting fellow cyclists. You can follow anyone on it.

Despite the individuality of cycling, there is a need to connect with other people who share this experience. There’s a social aspect to the sport, and it reflects the challenge we face with technology in health care today: Technology must be easy to use and deliver the human connection to improve a person’s health.

And nowhere is this more critical than in America’s rapidly growing senior population—a large number of whom are grappling with multiple chronic conditions.

Addressing Loneliness and Isolation

America’s seniors could benefit greatly from more human-centered technology. Three out of four Americans aged 65 or older live with multiple chronic conditions, and 71 percent of the money spent on health care in the U.S. is associated with chronic conditions. And the baby-boom generation is steaming into retirement, with 10,000 people a day aging into Medicare.

But health isn’t just about the physical aspects. Research has found that 17 percent of adults age 65 or older are isolated, and 26 percent are at increased risk of death due to subjective feelings of loneliness. If a person is living alone, and dealing with multiple chronic conditions, he or she might become depressed. People also won’t eat right or be active if they’re depressed.

Our species needs to connect with other people. Yet millions of seniors are lonely; they don’t have adequate social connections. That innate need to connect, to be social, and to be loved and to love other people is not being met in a large part of the population.

Things like remote monitoring technology can help, but only if it incorporates a person’s lifestyle and the physician/patient relationship. Technology has to go beyond monitoring basic physical activity. Devices have to achieve true connections and address real chronic health problems, like the nearly five million Americans in the U.S. who have congestive heart failure (CHF).

An Example of Connected Health

In order to help our members with chronic conditions spend more time living their lives by staying out of the hospital, we launched a CHF remote monitoring pilot program to help them keep track of their condition.

When a person has CHF, his or her heart doesn’t pump strongly enough to move blood around the body. As a result, the person retains water – in places such as the lungs, legs or chest cavity – and can suffer from shortness of breath. If the person experiences a significant change in weight from the previous day, this could signal a complication, which might lead to a trip to the hospital.

At Humana, we’re all too familiar with CHF. Approximately 300,000 of our 3.2 million Humana Medicare Advantage (MA) members live with CHF, and they account for more than 40 percent of MA admissions. Here’s how the pilot program works, with a member we’ll call “Brenda.”

After being selected, Brenda met with her primary care physician and a nurse. She was shown how to use a smart scale that would send her weight to Humana every day. When Brenda weighed herself the next morning, the scale sent her weight to her nurse, who called Brenda to congratulate her on her first weigh in.

If Brenda’s weight were outside an established range, her physician and nurse would be immediately notified. The nurse could then contact Brenda to see if she needed a new prescription or a consultation with the physician, enabling Brenda to have her weight fluctuation addressed immediately without having to go to the hospital.

Ease of Use and Human Connection

Members who participated in the CHF pilot program weighed in 88 percent of the time during the first 100 days. So why has this program been successful? There are two core elements: ease of use and human connection.

The table stakes for remote monitoring is ease of use. Brenda’s scale has no plug, no buttons, and requires almost no instructions. She doesn’t need Wi-Fi or Bluetooth to use the scale, and she doesn’t need to register it anywhere. Her scale simply works right out of the box. To be certain Brenda knows exactly what to do with her scale, she used it in front of her nurse as soon as she received it.

But to keep weighing in every day, this new activity has to be bonded to something Brenda values: human connection. Because Brenda knows her nurse is on the other side of the scale, and is looking out for her health and well-being, she is more likely to weigh in each day. Additionally, we have found that group enrollment sessions help people like Brenda because they see other people with CHF taking action to monitor their condition.

The program only works if people like Brenda take a small action each day. Technology can make it easier for Brenda to take that action, but in the end she will do it because of deeper, more human motivations like connecting to others.

There are other elements that help enhance the effectiveness of health-related technology, in addition to ease of use and the human connection, such as the motivation that comes as a result of a person seeing his or her specific progress (personalized, real-time, relevant information, aka the “so what”). This can be a powerful hook for encouraging ongoing engagement and helping people become more knowledgeable, and confident, in managing their condition. For example, the CHF pilot also includes sending “certificates of accomplishment,” recognizing those who’ve reached various milestones and that receiving recognition for their effort seemed to be an effective way of keeping people engaged.

The Way Forward

Health-related technology such as remote monitoring and scales can help our aging population improve their health. But it won’t do so unless the technology brings together the lifestyle and clinical aspects of a person’s health in a way that makes it easy to get people more engaged in managing their health.

The integration of physicians and clinicians, as we’ve seen with our CHF program, is important; their recommendations carry influence, and they can ensure that the data is used to highlight moments of influence. The key is not just the utilization of the technology; it’s the design and integration of the program. There is a real need for deep clinical engagement, both in getting people engaged in their health and in helping physicians and other health care providers move beyond prevention and wellness and toward managing chronic conditions.

At Humana, taking care of seniors living with multiple chronic conditions is what we do best. The role of technology is only going to become more important. But let’s never forget that technology must make things easier and more human to make a difference in health.

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Humana associate Dana Drzayich Antol, MS, a research consultant with Comprehensive Health Insights, recently won first place in the Psychosocial Support category for her team’s poster presentation at the Academy of Oncology Nurse & Patient Navigators’ (AONN+) Seventh Annual Navigation & Survivorship Conference in Las Vegas.

The team’s presentation — which was a combined effort between employees of Humana and Genentech Inc. — showed social support to be a moderator in the relationship between comorbidity medication adherence and health-related quality of life (HRQOL) for patients with metastatic cancer. Co-authors of this presentation included: Adrianne W. Casebeer, PhD, MPP, MS; Sari Hopson, PhD, MSPH; Raya Khoury, MPH; Aparna Parikh, MD; Alisha Stein, RN-NC, MSN, OCN; Todd Michael, PharmD, RPH; Stephen Stemkowski, PhD, MHA; and Mikele Bunce, PhD, MPH.

The study assessed HRQOL by having participants complete the Centers for Disease Control and Prevention’s Healthy Days survey. On its own, low comorbidity medication adherence adversely impacted the patients’ number of healthy days. The association between comorbidity medication adherence and the reduction in the number of healthy days was further amplified in the presence of patient-perceived fair or poor social support. These findings have important implications for improving or preserving the quality of life for patients with cancer.

The Academy of Oncology Nurse & Patient Navigators (AONN+) is the largest national specialty organization dedicated to improving patient care and quality of life by defining, enhancing, and promoting the role of oncology nurse and patient navigators. The organization, which has more than 5,000 members, was founded in 2009 to provide a network for all professionals involved and interested in patient navigation and survivorship care services in order to better manage the complexities of the cancer treatment process.

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Sometimes you need a little help when it comes to taking charge of your own health, making healthy choices and simply getting things done.

Humana offers a service called Humana At Home that is provided by Care Managers, nurses, nurse practitioners, home health aides, and other professionals to help people live safely at home, even when faced with medical, functional and behavioral health challenges.

The Humana At Home service includes in-home visits, telephonic advice, clinical care and in-home technologies that offer remote monitoring and other solutions. There’s even an Online Points of Care portal that helps members learn about and manage their health conditions, share updates with family caregivers and professionals, and access a national directory of vetted community resources for elder care and caregiving. Humana At Home professionals specialize in caring for older adults with multiple chronic conditions and functional, behavioral and/or cognitive limitations.

People who receive Humana At Home services live longer and go to the hospital less.

Eighty-nine percent of Americans over 65 want to live out their lives in their own homes. But a majority of members cite health problems as the No. 1 threat to their independence.

Many people are vulnerable not just because they are sick, but because they struggle with their daily activities. They might have trouble reaching for things in the pantry or bending to pick up a newspaper. The might have trouble preparing a meal, shopping or doing housework. Many suffer from short-term memory loss and have difficulty managing money or their medications. They might have trouble standing, walking or bathing.

These are real risks that make people more vulnerable to falls, accidents and hospitalizations. These seniors are more prone to malnutrition, infection and abuse. There’s a high degree of stress and anxiety about how to navigate the healthcare system.

In a fragmented health system, Humana care professionals offer a unique, holistic approach to wellness. Humana nurses and care managers can offer:

Medication management
Nutritional counseling
Home safety and falls prevention
Mental health support
Care coordination

A Care Manger might, for example, identify a community resource to help someone pay unpaid utility bills that otherwise could lead to a nonfunctioning refrigerator, spoiling insulin and limiting the person’s access to fresh food.

Field care managers visit Humana’s most vulnerable members to understand and address any factors that impact their ability to remain independent at home and avoid unnecessary hospital visits.

Our services are tailored to meet individual needs and circumstances:

Short-term after a hospital stay (Transitions)
Ongoing care (Telephonic and/or face-to-face)
Technology-enabled (Remote monitoring)
Preventive (Stay Healthy)
Community outreach (finding people who do not have phones)
Skilled care (Home health and nurse practitioner home visits)
Non-Humana members (Private pay)

It’s all designed to help us provide the right intervention, at the right time, in the right way, in the right place.

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Caregivers are trusted allies, so it’s no surprise that many people reach out to them for advice and guidance when it’s time to choose a Medicare plan.

There’s a large and growing number of people who are serving as caregivers to their parents, relatives and friends, many of whom don’t have the resources to conduct their own research. According to the National Caregiver Alliance, “approximately 34.2 million Americans have provided unpaid care to an adult age 50 or older in the prior 12 months.”

Caregivers are also clearly stretched for time, since many of them are working full-time jobs in addition to caring for a loved one.

So, if you’re a caregiver, help is on the way. Here are five simple tips to help evaluate Medicare plan options and aid in the enrollment process for 2017:

1. Allow yourself plenty of time

The Annual Election Period (AEP) for Medicare Advantage and Medicare prescription drug coverage began last month and runs through December 7. As the caregiver, make sure you and your loved one start early so you can make the right decision. Great sites, such as www.Medicare.gov and www.humana.com/Medicare, are excellent online resources for finding the right plans for the loved one you care for.

2. Confirm the prescriptions your loved one needs

Managing prescriptions drugs is not easy. When researching Medicare options, be sure to conduct an inventory of the prescriptions your loved one is taking. Write down the names, the dosages, when and how they are taken, and, where they’re being filled. Make copies of this list so loved ones and friends are in the loop, too.

3. Discuss preferences for doctor visits

If the person you’re helping to enroll in a Medicare plan is comfortable with a primary care physician coordinating their care within a network of Medicare-approved doctors, a Medicare Advantage HMO plan may be a good fit. HMO plans often have a low or even zero monthly plan premium, although the person you’re caring for will typically need to continue to pay his or her Part B premium. If the person you are caring for wants more flexibility in choosing a doctor, a Preferred Provider Organization (PPO) or Private Fee-for-Service (PFFS) plan may be a good plan option. There are also Medicare Supplement insurance plans, which allow more options for selecting a doctor. These plans don’t provide prescription coverage but a standalone prescription drug plan can be purchased as well.

4. Balance the budget with health care needs

Many people with Medicare are living on fixed incomes. This makes it critical to review any current Medicare health plan and take a close look at how much has been spent on health care during the past year. Be sure to include hospital expenses, pharmacy costs and doctor bills. This will help to determine—to the best of your ability—the health care expenses expected in 2017 and whether his or her current Medicare health plan still fits within the budget and household finances.

5. Communicate clearly with the care team

Involve everyone who needs to take part in making these decisions – children, siblings, friends, and other caregivers. By working together as a team–like you do in caregiving—you’ll be able to gather the best information. Others may have done this before, so share knowledge as you go.

Make sure you look at all plan options, including Medicare Advantage plans, the private alternative to Original Medicare. Medicare Advantage plans often offer zero or low monthly plan premiums (although, Part B premiums typically must continue to be paid), set cost-share, and lower or no deductibles compared to Original Medicare. These plans also offer maximum out of pocket cost protection.

Caregiving is a difficult task, but choosing a Medicare plan doesn’t have to add to the stress if you follow these simple tips.

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Humana has been named one of the 50 Best Places to Work for New Dads by Fatherly, an online resource that aims to be “the most robust source of practical parenting advice on the Internet.”

The publication cited Humana’s four weeks of paid paternity leave, our Health Savings Account, our PTO policy and “some of the most competitive salaries in the industry made even better with recognition pay for good performance.”

The article also mentioned our tuition-reimbursement and 401k policies, which helped make Humana “the top-ranked insurance company on this year’s list.”

Read more about Humana here.

See the full list here.

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