In 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 — Our journey for change…— is reprinted below. To see all of his blog posts, click here.
In every part of the business and public community we are all striving to find ways to improve our physical and mental health. Often I comment, no one organization will solve this problem, but working together – private and public organizations. In the context of working together, I thought it would be interesting to share some of our learnings over the last year.
In April 2015, my fellow Humana employees and I announced a Bold Goal: improve the health of the communities we serve 20 percent by 2020. Yet the Bold Goal is not just a journey; it’s become a passion that supports our Integrated Care strategy. We experience our Bold Goal every day. It challenges us to do our best, to rethink what we’re doing to address health, and to discuss what we’ve learned in these communities.
Sharing our learnings
The Bold Goal is aspirational, but it’s deeply accountable because we’re measuring our progress. We’re using the Centers for Disease Control and Prevention tool called Healthy Days, asking Humana Medicare Advantage members how many mentally and physically Unhealthy Days they’ve had in the last month.
I’m motivated by this measurement as it provides a holistic view of how we’re doing in assisting our members. Rather than just providing a view of a member’s physical/clinical health, Healthy Days provides a glimpse of their level of happiness and life satisfaction, which ultimately is the underlying purpose of health—to live a full and happy life.
At Humana, our strategy is to assist members in their journey of health by simplifying the experience and being proactive in helping them with their day-to-day health care and life needs. The core of our approach includes integrating five areas that are the most impactful in influencing health outcomes – Primary care, Pharmacy, Behavioral Health, Home Health and Social Determinants of Health.
We’ve seen firsthand the impact of focusing on these areas and have also learned that it’s critical to address them through a holistic approach to health. For example, we have 2 million individual Medicare Advantage members who are being cared for by primary care physicians in value-based agreements, and through a holistic focus on health, they’ve had the benefit of more Healthy Days. In Knoxville, this holistic approach led to a 1.5 Unhealthy Days reduction since 2015 by addressing poverty and diabetes. Another good example: Last year we helped our MA members have 89,000 fewer days in the hospital, or said differently—more days at home.
What we have also learned most in our Healthy Days measurement is the impact that social determinants of health have on an individual’s happiness. More specifically, the most impactful – affordability, loneliness, social isolation and food insecurity – can have a serious effect on a person’s health. That’s why we’re working directly with local organizations in our Bold Goal communities to address those needs.
The best way to explain the work of our Bold Goal—and what Humana stands for as a company—is to share with you our learnings about how we’re working to make a difference in the lives of our members.
I would like to share with you our experience helping “Betty,” a 78-year-old Humana Medicare Advantage member who is single and joined Humana a few years ago. Betty is independent and self-sufficient, and she enjoys cooking and gardening. She has children and more than a dozen grandchildren and great-grandchildren.
Yet Betty, like the majority of our members, is living with multiple chronic conditions such as diabetes, COPD and CHF. To make her situation even more complicated, Betty is caring for her adult son, who is disabled, so staying well and having more Healthy Days is a priority for her.
Based on a predictive model, we told Betty there was a high likelihood she would have a stroke within the year, but regrettably, she didn’t engage in the proposed clinical interventions. Sadly, she had a stroke and had to recover in a nursing home.
After Betty returned home, she was more open to intervention. She was enrolled in the Humana At Home telephonic chronic care management program, where she met Dawn, a Humana care manager assigned to help her. Dawn helped Betty live life on her own terms and as a result, she gained Betty’s trust and got Betty more engaged in her health.
Betty is now independent, back in her home and taking care of her son. Dawn also helped Betty address her fear of doctors, develop an action plan for COPD, find transportation resources, and enroll in Humana’s Mail Order Pharmacy. Dawn gave her the tools to take care of herself where she wants to be – at home. As a result, Betty’s story is a happy one—she’s better able to afford her medications; Social Services has helped with other social and financial resources; her A1C is down; she’s lost 15 pounds; her blood pressure is in normal range; and she has stopped smoking after 60 years.
For people like Betty, we have learned that the biggest motivating factor for engaging in their health is not necessary about seeing improvements in their physical health. Instead, it really comes down to life goals. For Betty, it’s about staying well and having more healthy days so she can be there for her son. So for us to help Betty and others, we need to understand both the health and life needs of our members.
Medicare Advantage is the right platform
Betty’s Medicare Advantage plan helped her regain her health—and her life. We have learned that this deeply integrated, experience-based system helps remove complexity from the system and incentivizes whole-person health.
More and more seniors like Betty are turning to Medicare Advantage because, on average, it leads to better health and a better experience. In fact, seniors, including those who receive their health care through their employer, are choosing Medicare Advantage in greater numbers than ever before. The program today has over 22 million members.
In a country where everyone is looking for ways to solve our nation’s health care challenges, Medicare Advantage is a proven public/private partnership that’s helping people like Betty live healthier lives.
If you would like more details on what we’ve learned and have shared serving our members in the communities we serve, please check out our annual 2019 Bold Goal Progress Report.
Read Full Article