Medicare Advantage

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 — How seniors can beat “diseases” like loneliness and social isolation — is reprinted below. To see all of his blog posts, click here.

Tivity Health, Inc. (NASQ: TVTY) Chief Executive Officer Donato J. Tramuto and I recently teamed up to draft the following blog post.

Health is personal. You might tell yourself that you alone have the power to make the lifestyle changes to eat better, exercise or meditate.

But getting healthy doesn’t have to be a solo act, because many of us face the same challenges. Individual resolve is important, but momentum is best maintained when we have a friend to encourage us to stay the course.

For many of us with active lives, it’s easy to find people like ourselves, whether it’s at work or through a social activity. But if you’re a senior who is lonely or socially isolated, it’s not easy to find encouragement and change your health.

Seniors face many health challenges that are not just medical

American seniors face significant health challenges. Many of them are living with multiple chronic conditions they may have for the rest of their lives, from diabetes to congestive heart failure. They may be on a fixed income, struggling to pay for prescription drugs.

Despite these challenges, there is also positive momentum in aging. Advances in science are helping America’s seniors live longer and stay active. For example, the Centers for Disease Control & Prevention say life expectancy in the U.S. is 78.8 years, and that could rise.

While seniors are living longer, there are other issues that can affect their health. For example, take the impact of loneliness on seniors. One study found that “loneliness has an equivalent risk factor to health as smoking 15 cigarettes a day, shortening one’s lifespan by eight years.” Research has also shown that social isolation can limit a senior’s ability to improve their health. For example, “6 million adults 65 and older have a disability that prevents them from leaving their homes without help.”

Living with chronic conditions is hard enough. When a senior does not have a support network of friends and family – people to socialize with and share common interests – the will to improve one’s health can be compromised.

As the leaders of Humana and Tivity Health, we’ve had decades of experience helping the senior community. We’ve found that the secret to improving their health is simplicity. It starts by offering them a platform to engage in activities that not only make them healthier, but help them connect with others.

Bringing people together helps improve health

At Humana, we’re helping more than 3.3 million Medicare Advantage members nationwide age with optimism, an approach that goes beyond conventional clinical treatments. Many of our members are living with chronic conditions, but they are more active than previous generations. For Tivity Health, which manages SilverSneakers®, we’re helping millions of people age into Medicare.

Our experience has taught us that social engagement leads to sustainable change. SilverSneakers® memberships, available through countless Medicare Advantage programs, give seniors access to a nationwide network of physical locations, as well as community centers, parks and social locations, where they can meet other people and engage in fitness classes specifically designed for their demographic. One survey found that “49% of active members said they were motivated to continue exercising because they had a friend in the program.”

And it’s more than just walking. SilverSneakers offers a wide variety of exercises and intensity levels, from dance classes to yoga sessions, as well as conventional cardio and weight-focused classes. SilverSneakers has entered into partnerships with more than 14,000 fitness locations nationwide as well as at Humana Guidance Centers. At Humana, SilverSneakers is included at no additional cost to the 3.3 million Humana MA members across the country.

SilverSneakers is a key element of many Humana Medicare Advantage plans because the proactive program takes a holistic approach to capture the senior’s complete health, not just the clinical.

In MA, we take a coordinated care approach, working side-by-side with providers who are in value-based reimbursement models with Humana. That means these providers are reimbursed for the health outcomes of our members (their patients), not just the services they provide. Programs like SilverSneakers perfectly align with the health-focused nature of Medicare Advantage.

Let’s learn from common purpose

The resolve to improve one’s health starts from within, but success requires perseverance and encouragement from friends and others who share the goals. Today, millions of seniors are not getting that support because they are socially isolated or lonely, and this has had a significant impact on their health.

Helping these seniors improve their health and well-being does not always have to start with a prescription or a visit to the doctor. Platforms such as SilverSneakers, supported through Medicare Advantage programs that emphasize health outcomes, can give seniors the social support they need and connect them with others who share a common purpose. This camaraderie ensures that seniors are not alone in their health journey.

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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 — Who are the forgotten soldiers of health care? — is reprinted below. To see all of his blog posts, click here.

If I were to ask you about the forgotten soldiers of health care, you might think about hard-working nurses and clinicians, or the ER staff that works diligently through the night. While these professions are absolutely critical to our nation’s health care system, my thoughts go closer to home, to family.

Think about how difficult it is to care for someone who is over 65 and needs assistance at home. Whether it’s managing multiple medications or monitoring blood-sugar levels, in-home care for an older person living with chronic conditions takes a team approach.

Primary care physicians can quarterback care and coordinate among specialists, and nurses can make sure care is efficient and consistent.

But beyond the traditional doctor/patient relationship, there is a forgotten soldier. This person is not a doctor or a nurse or a licensed care professional. Many times the person does not work in the health care industry. But they have the most unbreakable bond with the patient: They are family. That person is the caregiver.

And this was reinforced for me during a recent visit to Houston.

Meet “George”

While I was in Houston, I was fortunate enough to participate in an in-home visit with one of our members, “George.” I also met his wife, “Mary,” their daughter, “Beth,” and several members of George’s clinical team.

George is 71 years old and is in a Medicare Advantage PPO plan. He lives with multiple chronic conditions, including coronary artery disease and hypertension, and he has undergone a coronary artery bypass.

Living with these multiple chronic conditions is not easy for George, and it also takes a toll on Mary and Beth. Treating these conditions requires a holistic approach.

For example, Humana and our partners — physicians, nurses and clinical care experts — help care for George in a number of ways. He receives occupational therapy to strengthen his upper extremities and fine motor muscles, and physical therapy, primarily for his lower extremities and gross motor muscles. Under the direction of a care professional, George also receives support for personal care and activities of daily living, like feeding, showering, dressing, etc.

The Sit Down

Both George’s nurse and his therapist led the visit. His wife and daughter were there, too.

From the start, it was evident that the nurse and therapist had a strong, personal bond with George, Mary and Beth. The nurse and therapist, both of whom I could see were an unofficial extension of the family, understood the critical care and emotional support that Mary and Beth provided to George.

At the end of the 30-minute visit, I asked George what was most important about the care he received. He said he appreciated help from people with a positive attitude; he liked the quality of the interaction and not being “rushed;” and he noted the dependability of the team members, who always show up and follow through.

The care team benefitted too, enhancing their already deep, holistic understanding of George and reinforcing the bond of trust. It was clear to me that this care team – family and clinical – had been making a difference in George’s life, and that he was thankful.

The Importance of Caregivers

November is National Family Caregivers Month, a time to recognize the critical care provided by approximately 43.5 million caregivers. Their work had an estimated economic value of $470 billion in unpaid services in 2013. And with the senior population growing, many of us are going to find ourselves in the shoes of Mary and Beth – as caregivers.

These forgotten soldiers of health care will help determine how well America copes with the rising tide of chronic conditions. I’m encouraged, having seen firsthand how Humana’s Caregivers Network Resource Group is providing resources for our employees caring for family members and other loved ones.

While George has a very strong clinical team and family support network, there are many members who are not as fortunate. They are socially isolated and don’t have family to turn to for care. Their children may live in different cities. They might not have close relatives or friends.

This is the challenge, and we must be prepared.

It’s only going to become more common

In the caregiving world, relationships matter. Technology can help, maybe by building caregiver networks to identify people who have the time to help. But it’s not going to change health.

Technology is not a substitute for trust between two people. Basic human interactions can’t be replaced with a robot, an app or some other form of technology. It’s the low-tech and human efforts that are most impactful.

Our front-line associates know they can have an impact on the health, well-being and experience of our members. They are in this together, and they know it takes a team built on trust, empathy and emotion to make life better.

Mary and Beth are the unsung heroes, the forgotten soldiers of health care. They have an amazing impact on the people they care for, and on our health care system. You may also get the call – as a wife, daughter, husband or son – to be a caregiver. We need to ensure that we’re all prepared to receive this call, and to act on it.

 

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Maria Hughes, Humana’s Chief Inclusion and Diversity Officer, joined other business leaders in Louisville this week to talk about growth, talent acquisition and opportunities for 2018.

The panel discussion was hosted by Louisville Business First as part of its Grow Louisville event.

Maria said “it is vital to create a stimulating environment where diverse workers can be themselves and feel like each voice is heard and respected,” the newspaper reported. She also noted that “it is vital to attract the right talent that can fit well within a team structure.”

“It’s not just the mix, but making the mix work,” she said. “It’s having the environment in which people feel they can thrive.”

Click here to read the full article in Louisville Business First (subscription required).

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Forbes.com has reported on Humana’s value-based care report, noting that “As Humana Moves Doctors To Value-Based Pay, Medicare Costs Fall.”

“Humana’s shift from fee-for-service medicine to value-based payments for doctors is reducing costs and improving quality of care for seniors enrolled in Medicare Advantage plans,” the story said, citing the study.

The study found that “medical costs were 15% lower in Humana Medicare Advantage plans that paid physicians via value-based models last year compared to costs of those in traditional fee-for service Medicare,” the story noted.

Other highlights of the study include the fact that providers in value-based reimbursement model agreements with Humana had 26 percent higher Healthcare Effectiveness Data and Information Set (HEDIS®) scores compared to providers in standard Medicare Advantage settings based on an internal attribution method. Also, Humana Medicare Advantage members affiliated with providers in value-based reimbursement model agreements experienced 6 percent fewer hospital inpatient admissions and 7 percent fewer emergency department visits than members in standard Medicare Advantage settings. The number of preventive screenings was 8 percent higher for breast cancer and 13 percent higher for colorectal cancer.

“The Humana study is the latest evidence of the potential value-based models have at slowing or reducing spending on Medicare,” Forbes wrote.

Read the full Forbes.com story here.

You can access the full value-based care report here.

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On a beautiful October morning, the twice weekly Humana walking group was joined by a new participant, marathoner Kathrine Switzer. They peppered her with questions. What shoes does she wear? (She is an Adidas athlete.) What does she eat the night before a big run? (She loads up on carbs, but has also been trying to eat more protein, such as nut butters.) How does she handle aches, pains and injuries? (REST.)

Kathrine acknowledged that at age 70 she was the young one in the group, which includes a walker who will turn 90 in November and a couple of participants recovering from surgeries. After they all walked together, Kathrine stood in front of an even larger crowd and talked about how the body continues to improve as long as it is challenged.

“Look at those of you I walked with this morning,” she said. “When you started walking together, maybe you couldn’t go very far, but now you’re up to a mile or two or three.”

Kathrine regularly runs long distances, but during her presentation she said the SilverSneakers® Stretch class at the Louisville neighborhood location “killed” her, in the best way. “At any age, the body can get better… the more you do, the more you can do.””

Her message was well-received. One 84-year-old in the audience told Kathrine she had recently started running again. Kathrine applauded her and every other person in attendance who was getting up and getting moving.

“Every time you take a class here or every time you walk with your friends, you come back and you feel much more optimistic,” Kathrine said. “Suddenly everything becomes more positive and optimistic. That’s the way to go into your life.”

One of Kathrine’s next challenges is the New York City Marathon on Sunday, November 5. And she will have a new group of fans rooting for her from Louisville, Kentucky.

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