Bruce Broussard

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 — 21st Century Solutions for 20th Century Problems — is reprinted below. To see all of his blog posts, click here.

We all know health care is being transformed: from the emergence of remote, real-time monitoring to the continued adoption of value-based-care payment models, disruptive technologies are improving health care.

Yet despite the progress, health care is facing challenges.

Take demographics, such as population. Each day, 10,000 Americans turn 65, and the number of people over 65 is expected to grow from 46 million today to 98 million by 2060. We’ll need more caregivers, as there are now about 34.2 million people who have provided care to an adult age 50 or older.

Now look at the health of those people. Three in four Americans over the age of 65 are living with multiple chronic conditions. Unlike episodic treatment, caring for those with chronic conditions requires proactive prevention, assistance with lifestyle decisions, and multiple specialists to treat complex, serious diseases such as congestive heart failure, diabetes, etc.

So with more unhealthy people over the age of 65, how do we prepare primary care physicians, nurses, social workers and caregivers to handle this wave of change?

Primary care physicians are the centerpiece

These population and health factors are putting significant demands on nurses, social workers, pharmacists and primary care physicians who assist people living with chronic conditions.

Research has shown growing demand for these key professions. For example, there is a projected shortfall of between 14,800 and 49,300 primary care physicians by 2030.

These demographic and health challenges require the health care system to evolve – away from episodic care and toward holistic health, where the care for a person living with multiple chronic conditions is managed by the primary care physician.

If we’re to help prepare the next generation of health professionals, their education and training must evolve as well. Clinical models that slow disease progression and payment models that incentivize quality and cost savings must be integrated into the system. In addition, daily workflows that allow more time with fewer patients are essential.

Yet it’s not just the clinical. It’s important to partner with local charities and community agencies to address social determinants of health – food insecurity, social isolation and loneliness.

Medical schools are starting to change

Today, a select number of medical schools are evolving their curriculums to help the next generation of clinicians, including primary care physicians, embrace holistic health.

Holistic care is most effective when care is integrated, which occurs when multiple clinicians (e.g., physicians, nurses, pharmacists, social workers and optometrists) are all aligned in a value-based model and working with one another to deliver a better patient experience and better outcomes. We need to build an integrated educational system to care for patients in this value world, and everyone has to work well together to make this a reality.

Recently, Humana and the University of Houston’s newly established College of Medicine announced that we’re going to build the Humana Integrated Health System Sciences Institute at the University of Houston. We’ll train physicians and other clinicians in integrated care delivery through a collaborative partnership with a focus on “advancing population health, improving health outcomes and expanding the use of value-based payment models.”

The new school will also integrate Nursing, Optometry, Pharmacy and Social Work. Social workers will be an integral element for taking care of underserved populations because they’re a key link between patients and community resources.

Working, thinking and building differently

Better management of chronic conditions, and addressing the social determinants of health that amplify them, is essential for transforming our health care system.

If we want to help primary care physicians and clinicians, then all entities in health care — universities, industry and government — must band together to advance the science of primary care. We’re moving to a consumer-focused health care system that’s integrated and personalized, and it will improve the health of the people it’s meant to serve.

Advancing care means we have to work differently, think differently and build differently.

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Work has changed in America, and our notion of work is evolving along with society.

Thanks to advances in science, from antibiotics to vaccinations, life expectancy in the U.S. has increased. In 1900 it was 46 years for men and 48 for women; it’s now 77 years for men and 81 for women.

Today’s work environment is less dangerous and taxing, thanks to a century of new safety laws, machines and computers that have transformed offices and factories. The demands on our lives and our bodies are not what they once were.

People also have more opportunities due to advances in transportation, with breakthrough ideas like ride-hailing apps and rapid light rail. Such options within cities are enabling many, particularly seniors, to get out of their homes more often.

But our views on retirement — a concept introduced in 1935 with the passage of the Social Security Act — have not kept pace. There is still a negative bias in how we view people over the age of 65. That needs to change, because there is nothing but disruption on the horizon when it comes to aging.

It’s a “Booming” World

Baby boomers are demanding better, in all aspects of their lives, and businesses will have to find new ways to market to these new “seniors.” That’s why I turned to an expert on how the U.S. business community is missing the mark when it comes to helping boomers age into retirement.

I recently asked Joe Coughlin, author of “The Longevity Economy,” to speak at a company leadership meeting. Coughlin says the older adult market is misunderstood, and he cites several examples, both good and bad, of how companies try to serve them.

Here are some of my observations from the book and Coughlin’s visit with our team.

Product design needs to address the needs of seniors. One of the main takeaways I had from the book, and from my talk with Joe, is the importance of respectfully designing products that address the needs and desires of older adults. That means treating them not as a set of problems but as “full-fledged members of society with recognizable wants, needs, and ambitions,” as Joe puts it.

In many cases, products are designed by young engineers who don’t understand or account for the needs of seniors.

Coughlin cites BMW’s 2001 debut of “IDrive,” a joystick designed to simplify dashboard controls. Coughlin says many people hated it, especially seniors. That’s an issue because older people are a big part of BMW’s customer base. Although BMW fixed the problem, it’s a great example of older adults not being part of the design process.

65 is no longer the real retirement age for baby boomers and countless others. More and more boomers are remaining in their current jobs or choosing others, which is a good thing when you consider the brain drain. When we think of retirement, we traditionally think of age 65 (Medicare eligibility) with Social Security now kicking in at age 66. . But let’s be honest: For many, age is only a number; it’s not an indication of ability.

A few years ago, I wrote on LinkedIn about how my own father got bored in retirement and went back to work as a network engineer (Update: he stills loves doing it and feels it’s given him a real boost in his life).

It’s clear that my father and tens of millions of others are not going to fade away, but live life on their terms. More and more boomers are raising their grandchildren, going back to work, and starting their own businesses.

A bias in how seniors are portrayed in the media is not helping matters. Coughlin explored the misperceptions around older adults and how many of us “expect older people to live apart, quietly sequestered away in retirement communities, assisted living facilities, and nursing homes, surfacing to shop and dine only when everyone else is at work.”

This negative perception reminded me of how my company sponsored research examining the negative stereotypes of seniors in the 100 highest-grossing movies of 2015. The research showed that seniors were ridiculed, as well as “underrepresented, mischaracterized and demeaned by ageist language.” Findings also showed that “out of 57 films that featured a leading or supporting senior character, 30 featured ageist comments.”

At Humana, we’ve done our own research which shows that aging with optimism improves a person’s health. We also firmly believe that older adults are solid contributors to the workforce because of the proven skills, capabilities, and experience they bring.

Every stage in a person’s life needs to have a clearly defined purpose, especially the last one. Coughlin writes that there are four “chunks” of life, each of which is composed of roughly 8,000 days. The first covers birth to college; the second, college to midlife; the third, midlife to retirement; and the last covers retirement and beyond.

An 8,000-day chunk is about 20 years. Yet while it’s easy for many of us to plan for the first three “chunks,” we need to realize that the last one could go on much longer than two decades. We as a society need to embrace retirement as useful longevity.

Today’s 65-year-old is very different from today’s 85-year-old. That’s why personalization and understanding the stages in 8,000 days is critical. With Baby Boomers now aging into their unique and dynamic version of retirement, just imagine what this new generation of seniors will be able to accomplish from ages 65 to 85, and beyond.

As a person’s health, financial and social needs increase with age, there is an opportunity not just to guide people through the fourth “chunk,” but to help them live life to its fullest potential.

The path forward

We need to look at older adults as a very active, very participatory segment of our society. They’re going to retire the term “retirement.” And that’s a good thing.

At Humana, we’re committed to addressing the needs of our 3.3 million Medicare Advantage members. Every one of our members is unique, and they certainly do not intend to fade into the background at age 65.

The Baby Boomers will change the concept of retirement, and the American business community will have to innovate in ways that meet their needs. Let’s harness the power of imagination to help seniors live their best lives.

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“In the event of a loss of cabin pressure, be sure to put your oxygen mask on first before assisting others.”

You’ve heard some variation of these words if you’ve flown on a plane. It basically means you need to take care of yourself first before you can help anyone, or you’ll be of no help to anyone.

Yet it’s a concept that, unfortunately, is a challenge for providers and caregivers in health care. Many are working longer hours and have greater workloads. The increasing demands of increasing chronic conditions, the aging population and demands on daily lifestyle are making it harder for us to take care of ourselves.

When employees find that they are faced with new responsibilities of providing care to a family member or friend, things just get tougher. And with 10,000 baby boomers every day turning 65 and inching toward retirement, the American workforce is going to have its lack of time challenged even more by caregiving.

A second job

According to the Family Caregiver Alliance, “34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months. And this recent article — “America Is Running Out of Family Caregivers, Just When It Needs Them Most” – details the challenges of the people who need care:

•   “Their (Americans reaching retirement) median incomes, including Social Security and retirement fund receipts, haven’t risen in years. They have high average debt, some incurred from taking care of their own aging parents. And if they’re counting on family to care for them, too, they may well find their families too small and far-flung to meet the task.”

Similarly, there is another group that is critical in addressing caregiving: the physicians and clinicians who deliver clinical aspects of care.

And are they putting their own oxygen masks on first?

Physicians and clinicians need more help

According to a recent study of nurses, “nearly all respondents (92 percent) had moderate, high or very high levels of work-related stress” and “69 percent of respondents reported no regular exercise.” On the physician front, it’s even more alarming. One study found that 90 percent of physicians were not willing to recommend their profession in health care.

The frustration and struggles voiced by physicians and clinicians could not come at a tougher time. Given the large number of people entering retirement, we simply won’t have enough physicians and clinicians to meet the needs of the exploding boomer population, within current care models. Even with promising technology and new care settings like in the home, covering the expected shortages of clinical talent will be a real stretch.

Physicians and clinicians are already struggling, and they need support now. And the first steps can be taken with employers.

Employers in the health and well-being space can help create a more positive future for physicians and clinicians. For example, at my company Humana, we’re focusing on building a culture where our physicians and clinicians can thrive – personally and professionally. We want to fully empower their efforts to have successful careers, make an impact in the lives of those served, and truly be supported in their own health and well-being journeys.

Today, we directly employ or have received direct support from approximately 8,200 clinicians (e.g., physicians, nurses and other clinical positions) who serve our 3.5 million Medicare Advantage members and others.

We also just finalized an ownership stake in Kindred at Home and Curo Health, who also employ thousands of nurses. Over the next few years, we expect clinical talent like physicians, nurses and pharmacists to become a very significant portion of our workforce.

Moving in the right direction

Employers like us who envision a renewed, world-class experience for clinical caregivers need to make it easier for physicians and clinicians to do their important work. Guided by listening and learning from the front lines, we’re focused on simplifying workflows and a new generation of care technology. Things that make it easier to provide care and clinical expertise also decrease added stress and help clinicians better fulfill their personal purpose: helping people. Professional growth opportunities that develop newly evolving skill sets and broaden learning are also helping prepare the workforce for the needs of the future.

The oxygen mask starts, however, with helping clinicians improve their own personal health and well-being. The American Heart Association has recognized our efforts in that area, and bestowed upon us the Workplace Health Achievement Index gold award. According to the AHA, our performance was assessed on the basis of evidence-based strategies and scientifically validated measures of health among 200 clinical companies and roughly 1,000 others.

Yet despite the success we have achieved this early in the game, we know it will take years to reach our goal. We also need to pay special attention to the roles that employees play as family caregivers. As an example, we’ve recently provided an additional benefit of two weeks of paid caregiver leave to our associates, and formed a network resource group where family caregivers can connect and share mutual support. It’s not easy for anyone to navigate today’s complex, disconnected health care system, especially given the lack of time and resources they have when it comes to their full-time jobs.

We’re at a critical time in health care. Everything must not rest solely on the backs of physicians and clinicians; employers need to ensure that their cultures support clinical talent where applicable and support employees who are called on to provide care. For the U.S. to retain its competitive advantage, we need to support and strengthen those who care for our loved ones.

 

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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 — Want success? Be prepared to fail — is reprinted below. To see all of his blog posts, click here.

“No pain, no gain” is a mantra for many people who exercise, motivating them to lose weight or get in shape.

Yet in other facets of our lives, we reflexively avoid pain, adversity and even uncertainty. A potential entrepreneur may hesitate to launch a startup because it could fail. A student may avoid law school for fear of the bar exam. Or a leader not open to new ideas could hinder a company’s ability to capitalize on opportunities.

It’s part of human nature to avoid pain. But pain, adversity and uncertainty, despite the hardships they bring, are where you can truly experience life. If you think about it, avoiding pain in its entirety can make you miss life’s real rewards.

Take the book “Principles,” by Ray Dalio. He’s the founder of Bridgewater Associates, a highly successful financial services firm. In the book, Dalio examines the concept of decision-making and provides a way for the reader to create a series of life principles and work principles. An underlying theme is our aversion to pain; Dalio advises us to embrace reality and deal with it, as opposed to ignoring it.

Dalio developed these principles after watching his startup business grow to 16 people and then shrink to one employee – himself. He had been “dead wrong” on a critical financial venture. Dalio realized that if he “was going to move forward without a high likelihood of getting whacked again, I would have to look at myself objectively and change.” Enter the concept of principles.

Here are three key takeaways from some of the principles in Dalio’s book and how his principles might not only help you, but also help change health care.

Be prepared to fail well. It’s good to fail. We’ve all done it. And if we learn from failure, better things will come from it. In Principles, Dalio writes:

“Everyone fails…The people I respect most are those who fail well. I respect them even more than those who succeed. That is because failing is a painful experience while succeeding is a joyous one, so it requires much more character to fail, change, and then succeed than to just succeed.”

In our careers, we tend to think failure can set us back years. Yet some of the greatest mistakes — from Steve Jobs being booted from Apple, the company he founded, to Thomas Edison’s 1,000 failed attempts to create the light bulb — paved the way for transformational success. Dalio says mistakes are “a natural part of the evolutionary process.”

So if failure knocks you down, like it has done for many of us, you’re certainly not down for the count. You have the choice to rise back up and get closer to success. In any career journey, Dalio writes, failures “can either be the impetus that fuels your personal evolution or they can ruin you, depending on how you react to them.”

Health care needs to fail like Thomas Edison failed. There have been many attempts to rein in health care costs. But focusing on costs won’t solve the core issue, because costs are a reflection of our society’s unhealthy lifestyles. I’ve seen that a broader approach, designed to help people change behaviors at all phases of life, will help bring down these rising costs. It’s not going to happen overnight for all of us, but if we keep at it and learn from our mistakes, it will.

Experience life by being less pain-averse. Failure can lead to pain, but if you can open yourself to more difficult situations, you’ll enhance your chances for long-term success. It’s important to realize that if you want to succeed, you have to be willing to get comfortable being uncomfortable, and you can do this by embracing difficult situations. The journey – good and bad and everything in between — is where life happens.

If you can move beyond being pain-averse and push ahead when things get difficult, you’ll be heading in the right direction. As Dalio says:

“Every time you confront something painful, you are at a potentially important juncture in your life—you have the opportunity to choose healthy and painful truth or unhealthy but comfortable delusion.”

Health care is changing, and change can be difficult. I’ve been in the health care industry for decades, and the industry is heavily focused on how new technologies, from blockchain to artificial intelligence, can deliver better patient care. Health care is also changing from episodic care to focusing on managing health holistically, recognizing the importance that lifestyle plays in overall health. Getting comfortable with these changes will almost certainly improve the lives of many people.

Be open-minded, radically open-minded. You can fail. You can make mistakes. But you need perspective, beyond your own, to make use of these experiences. Being open to diverse points of view can only make you better. You might have issues, as a leader, not knowing all the answers. Yet in my experience, I’ve seen that the best leaders are the ones who seek out fresh perspectives.

Dalio encourages radical open-mindedness and radical transparency, which are “invaluable for rapid learning and effective change…Being radically open-minded enhances the efficiency of those feedback loops, because it makes what you are doing, and why, so clear to yourself and others that there can’t be any misunderstandings.”

For example, take a look around your office. If you have diversity of thought, diversity of culture and diversity of males and females – but don’t have an inclusive environment where people feel welcome and safe to be their true selves – it will be difficult to create new ideas. Being open-minded and seeking alternative opinions is an important part of being a good executive, family member or community leader.

Health care does not have all the answers. Our industry has made tremendous advances, but to continue this momentum, we must look outside our industry for answers, starting first with the perspective and needs of health care consumers. The industry also needs to listen to and partner with physicians and clinicians, as they play the most critical role in improving patient health.

Health care is evolving. For the benefit of health care consumers, it’s time to get comfortable being uncomfortable.

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Making the best of your retirement means tending to your health as much as your 401K, IRA or stock portfolio, says Humana President and CEO Bruce Broussard.

Bruce recently wrote a blog post for CNBC.com about the importance of taking care of your health in advance of retirement. He noted that three in four Americans aged 65 and older have multiple chronic conditions

You can read Bruce’s post here.

“When people reach retirement, they believe they can make up for decades of unhealthy behaviors — like sedentary lifestyles or poor eating habits — because they won’t be working as much and will have more time,” Bruce wrote. “While improving behavior will help at any stage, it won’t make up for years of unhealthy actions that have led to chronic conditions — from diabetes to heart disease.”

He said that having better habits now will pay big dividends later, and that the industry is evolving to make that easier.

“Technology is going to disrupt the health care experience, and it will enable us to have a highly detailed understanding of our core health numbers through advances in things like wearables, remote monitoring and electronic health records. But opening apps on your phone will only go so far,” he wrote. “Changing unhealthy behaviors starts with the individual. We all need to manage our health with the same vigilance we use for financial retirement planning. We should know our BMI numbers as well as our 401K balances.”

Read the full blog post here.

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