community health

Humana has released its “Bold Goal – 2017 Progress Report,” showing the strides the company has made – along with physicians and local community nonprofit, government and business partners – toward improving the health of the communities it serves nationwide.

As stated nearly two years ago, Humana’s Bold Goal is to make the communities it serves 20 percent healthier by 2020 by making it easy for people to achieve their best health.

The latest numbers show that nationwide, more people are experiencing Healthy Days, a U.S. Centers for Disease Control and Prevention (CDC) measurement that reveals how a person is feeling holistically, including his or her mental and physical health. The report shows a 2 percent improvement in Healthy Days on a national basis among Humana’s membership.

Humana continues to work with targeted Bold Goal communities to support local public health and care-intervention programs. This collaboration has helped improve Healthy Days by a margin of 3 percent in these communities. Six of Humana’s seven Bold Goal communities have seen improvements in Healthy Days.

And Humana’s 50,000 associates (employees) are still on track to improve their overall Healthy Days by 20 percent by the end of 2017. Associate experiences found to be particularly successful will be replicated in local communities.

Creating lasting behavior change in the communities Humana serves requires highly local and holistic care solutions that focus not just on clinical measures but social determinants of health. This demands a deep understanding of the fabric of local communities.

This approach, which Humana has emphasized in its Bold Goal communities, specifically addresses how social determinants such as food insecurity, health literacy and transportation can significantly impact an individual’s health.

Collaborating with local entities has been key, and the latest report details Humana’s work with physicians and community partners in places such as San Antonio, Louisville, Tampa Bay, Broward County (Florida), New Orleans, Baton Rouge and Knoxville.

San Antonio, Humana’s first Bold Goal community, experienced a 9 percent decrease in the number of Unhealthy Days, partly by addressing barriers to health in the community such as food insecurity and limited access to behavioral health services. Through a telepsychiatry pilot program and food insecurity screening implemented in primary care offices, these health barriers were directly addressed. Improvements in diabetes management were also achieved through collaboration between Humana, the San Antonio Health Advisory Board and the American Diabetes Association.

The community of Tampa Bay, one of Humana’s largest Bold Goal communities, has been working to address the issue of food insecurity through initiatives led by primary care physicians. The Tampa Bay Health Advisory Board and Humana, in partnership with Feeding Tampa Bay, the University of South Florida and other community partners, developed the Hunger Action Alliance to confront this issue.

In Louisville, Humana and community partners addressed respiratory illness, depression and behavioral health, including the Bold Moves Against Suicide Summit, which brought together more than 200 thought leaders, physicians and community partners to address the issue. While Louisville has the fewest number of Unhealthy Days compared to other Bold Goal communities, the city did not see an improvement in Healthy Days from 2015 to 2016. Humana has a number of initiatives planned for 2017, including intervention programs in partnership with the Louisville Health Advisory Board, to help accelerate Louisville’s progress.

Through its Bold Goal program, Humana has found that making communities healthier demands an integrated approach.

“Improving the health of an entire community is difficult, and no one person or organization can do it alone,” said Bruce D. Broussard, Humana President and CEO. “The progress we’ve made is encouraging, and we owe a large part of that success to the many different physicians and community members who have come together to make Humana’s Bold Goal a reality. Putting a stop to preventable diseases and improving the health and the lives of the people we serve are efforts worth fighting for, and we will continue to take what we’ve learned to add more Healthy Days into people’s lives.”

This year, the company is expanding the Bold Goal to other communities, focusing on strategies with the most impact on health outcomes. Humana plans to quickly determine what initiatives are effective and then scale them to achieve a community-level impact on health and Healthy Days.

Read the full report here.

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Investing in population health and value-based medicine helps our communities but also makes good financial sense, said Dr. Roy Beveridge, Humana’s Chief Medical Officer, in a blog post for Forbes.com.

“Healthy people spend more time enjoying life and less time in hospitals,” Dr. Beveridge wrote. “Health plans pay fewer claims when their members are healthier, and those members spend less out of their own pockets. When people are healthier, they have fewer unplanned and avoidable physician office visits. This frees up physicians to focus on wellness and disease prevention–things like flu shots and diabetes prevention–while also allowing time for their sickest patients, those who need them most.”

It makes sense to understand and try to influence the local, social and environmental factors that affect people’s health, he wrote.

“A better healthcare model is one that makes people healthier by reducing health barriers, promoting disease prevention and ensuring a dedicated focus on the sickest among us. It is not simply taking care of people when they become sick. It is working to prevent people from becoming sick.

“This is a win-win for all: healthier people, improved quality and lower costs. It’s the promise–the trifecta–of population health, and it leverages the concept of value-based care by paying physicians for the health outcomes of the populations they serve, not simply for the services they provide.”

Factors such as air quality, sedentary lifestyles, food insecurity, transportation and social isolation have a big impact on health, and no community is the same.

“Health must go beyond health coverage and clinical services and address these frequent social factors that impact people’s daily lives,” Dr Beveridge wrote. “Population health is about understanding the impact of these local elements and addressing and integrating them in a holistic approach with the clinical elements.”

Read the full blog posting here.

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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 — Can Car Factories Teach Us About Health Care? — is reprinted below. To see all of his blog posts, click here.

We’ve all owned a car that went far longer than we expected. Maybe it was the extra maintenance that helped extend it to 200,000 miles. Or we just benefited from a well-built car. Or maybe it was a little bit of both.

Yet one thing is certain about a car: the longer you own it, the more things will break. To get a high-quality, long-lasting car – successfully assembled from hundreds of parts – you need integration. You have to design around a specific outcome and meet multiple production-line goals.

Despite this massive complexity, the deliverable is simple: a healthy car that runs. In the world of health care, we have a fragmented system that’s delivering uncoordinated care to hundreds of millions of people. Yet this fragmentation leads to a question: What is the goal, and why aren’t we aligned?

The Product, Not the Components

A fragmented system is an inefficient one. An interesting story in The Economist examines how “innovation and production are increasingly interwoven” in auto manufacturing and how “linking the design of both the product and its manufacturing process more closely to production can help improve all three.”

So what does an improved process in the automotive industry have to do with making a person healthier? The answer is that in the world of manufacturing, advances in technology enabled the industry to better define a finished product. The automobile industry was able to integrate highly specialized functions, from the supply chain to product design, to deliver a consistent product and a user experience specialized to the user.

In health care, the definition of a finished product, the patient’s health, is not easily defined. Is it to restore or maintain health? If so, in what context? Do you do this for the day, the week, the year, the condition, or something else? Physicians have different perspectives given the individualities of the people they serve. It’s even harder given the numerous people who serve the patient, including a multitude of specialists, and no centralized point of care.

Impact of Specialists

Let me be clear. The growth of specialists in health care has been a positive thing, and it’s enabled millions of Americans to live longer. Specialists will be absolutely critical in helping people manage their chronic conditions.

Yet primary physicians, whose role is to coordinate patient care among the specialists, account for only 30 percent of physicians in our country while specialists account for 70 percent. Some experts argue that the ideal system should be the opposite. One story also found that the “primary-care gap is particularly acute in about one-third of states, which have only half or less of their primary-care needs being met.”

Our health system has a significant number of independent specialists, but they’re not integrated to deliver the connected patient experience. When health care became more contemporary in adding value to society in the previous century, it was because the general hospital and the primary care physician started to collaborate together to serve people under one roof.

It’s the same thing with manufacturing; the parts are collected, and the car is assembled under one roof. By mastering this global assembly and integration, the automobile industry has been able to successfully and efficiently deliver an experience that represents the personality of the car a person chooses, all in an affordable manner. Can it be said that health care has this level of integration that enables a personalized experience?

Elements for Success

Helping people with their lifestyles is critical to this structural change. In the past, it was episodic care — you needed surgery for a broken arm or a heart attack. While these are obviously still critical services, the health challenges of the 21st century will be ones of chronic conditions that start to show themselves dramatically as we age.

We have an obesity epidemic and sedentary lifestyles. People have access to manufactured, less-healthy foods, and there’s the stress and strain of living in today’s fast-paced, digital environment. All that sugar you ate won’t impact you at 50, but it sure will at 70. It’s a recipe that leads to poor health.

To bring affordability to health care, we have to talk about the ineffective structure of the health care system. By focusing on health outcomes – and paying doctors based on those outcomes instead of services performed – we will bring about change. If we really seek to lower the cost of health care, we have to focus on individual health outcomes, integration of care, and provider motivation.

Achieving affordability in health care requires us to address three core principles:

 · Define the Outcomes (Products). Given the multiple specialists that will be necessary for helping treat a person’s chronic conditions, there are naturally going to be different diagnoses. The health care industry of the 21st century must focus on a consistent definition of the individual health outcome, aka the product, and provide an engaging experience tailored to the personality of the person. This outcome must reflect the person’s health and well-being, not just how the patient responds to specific disease treatment.

 · Structure for Motivation. Today, physicians are reimbursed for the services they provide (fee-for-service), which can lead to increased utilization and duplicative services. In a value-based world, physicians are reimbursed for the health of the people they serve. More than 1.6 million of Humana Medicare Advantage members, on average, experience better health and improved quality from the physicians who serve them. Value-based care will help structurally change incentives in health care to keep the focus on the health of the individual, not the services performed.

 · Integrate the System. Given the fact that 10,000 people a day are aging into Medicare, combined with the fact that “chronic diseases account for 86% of our nation’s health care costs,” our health care system must have an integrator to address these demographic changes. The primary care physician is the key to integrating the myriad of specialists who serve the individual. As advances in medicine and technology increase life expectancy, we know the “car” will eventually break down. In a health care system centered on value-based care, it’s not about the parts; it’s about holistic mental and physical well-being.

Driving affordability into the health care system requires us to go beyond health access to address cost and a fragmented delivery system. We must move beyond the fee-for-service environment that just encourages services, not measurable impacts.

We need an integrated system that is financially incentivized to reward for optimal health, not optimal utilization. Only by integrating the clinical, health and lifestyle components, with a personalized, high quality and efficient experience as the end product, can we help transform health care.

If it can be done for cars, it can be done for people.

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The idea of using “experience groups” – asking people to describe in real terms what their everyday lives are like and then acting on the insights – is gaining traction among health care providers and employers, according to a story in The Wall Street Journal.

Humana’s Tim State, Vice President, Associate Health and Well-being, spoke with the newspaper about how Humana has used experience groups to improve the company’s employee health-and-wellness offerings.

Tim noted the importance of social influence on health. He said the experience-group discussions reinforced the idea “that people often will improve or worsen together.”

“As a result of the discussions, Humana developed more team fitness activities, such as group step challenges, so workers could inspire each other to better health,” the newspaper reported. “It also loosened its dress code to business casual so people would feel more comfortable moving around. And when many of the employees talked about having limited time to devote to health and fitness, Humana began allowing some workers to dedicate part of each workweek specifically to those activities.”

Read the entire article here.

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Humana Pharmacy in Phoenix recently donated more than 3,000 pounds of diabetic supplies (four pallets), including insulin syringes, pen needles, and test strips, to Insulin for Life USA, a nonprofit that provides insulin and disease management supplies free of charge to those with diabetes in developing countries who otherwise would go without these lifesaving provisions. The supplies were unused and unopened and returned by members for various reasons to the Humana Pharmacy dispensing facility in Phoenix. Due to various state pharmacy laws, Humana Pharmacy cannot redistribute these items to other members. Rather than let these items go to waste, Humana Pharmacy teamed up with Insulin for Life USA to provide people with diabetes in places like Barbados, Belize, Cayman, Ghana, Guyana, Haiti, Jamaica, Mexico, Nicaragua, Nigeria, and Uganda access to tools to help manage their diabetes.

According to the International Diabetes Federation, an estimated half a million children worldwide below the age of 15 are living with type 1 diabetes, with thousands of newly diagnosed children every year. Especially in developing countries, these children suffer and sometimes even die due to a lack of insulin and supplies.

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