Dr. William Shrank

“As America strives for positive changes to the healthcare system, it may find the greatest advancements for value-based care in Medicare Advantage plans,” according to an article by HealthPayerIntelligence.com.

Dr. William Shrank, Humana’s Chief Medical and Corporate Affairs Officer, was interviewed.

“We can be flexible, personalize, leverage, and a remarkable data source to be both precise about the needs of members, and to share that data with providers in a nimble way,” he said. “So if a provider is taking risks in partnering with us as compared to doing so directly with the government, we think there are a lot of advantages.

“As a result, we’re able to really accelerate the move towards value-based care and the likelihood that we will be successful in that endeavor.”

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“Baby boomers are claiming they don’t want to age the way their parents did. What do you think this means?”

That’s the question Humana Chief Medical Officer Dr. William Shrank asked three highly esteemed former U.S. Surgeons General during a recent Humana-sponsored panel at ICAA 2019: Shaping the Future of Wellness, this year’s International Council on Active Aging Conference, Leadership Summit and Expo. And while the Surgeons General interpretations of the “new future of aging” may vary slightly, everyone agrees it’s a topic that deserves more attention from the healthcare industry and those caring for aging adults.  

Dr. Richard Carmona, Dr. M. Joycelyn Elders and Dr. Antonia Novello took the stage with Dr. Shrank in Orlando on October 11, and passionately discussed how today health care system can improve to care for a growing senior population.

Consider that by 2030, 20 percent of the U.S. population is projected to be 65 years or older. With the three former Surgeons General aged 69 or older, they each spoke from personal and professional experience. Each Surgeon General shared their observations on the need to better care for seniors in America, as well as their anecdotes on personal experiences with aging. All were steadfastly in favor of supporting cognitive brain health for seniors, as they see mental health as the bedrock for preventing and managing chronic disease and social determinants of health.

Some of the most memorable takeaways from the panel include:

  • The interdependence of social challenges
    • Dr. Shrank explained how some of the biggest challenges seniors face are social. We as a country are wildly over indexed in paying for health care, and extraordinarily under indexed in taking care of our people,” he explained when talking about social issues, like loneliness, and the impact they have on the current system.
  • Understanding the cultural and social needs for seniors
    • Dr. Carmona shared a touching story about an older woman he had met years ago while traveling. The woman was born in a small village and grew up to become the matriarch of the area, teaching and showing others how to live, grow crops and work with one another. This maintained a sense of belonging and community. She was 106-years-old, but had a sense of purpose, and a true role of importance to others. Culturally, the woman was revered, valued and admired in her community. Dr. Carmona explained how we need to give seniors today the same continued purpose surrounded by a network of social connections. These are key components to preventing loneliness.
  • Addressing brain health and the rise in dementia
    • Dr. Elders shared powerful words when it comes to dealing with brain health. “My brother used to pray every day that his body doesn’t outlive his mind,” she said. Unfortunately, figures show the longer someone lives, the more likely it is they develop dementia. Dr. Elders explained the importance of having a care infrastructure that addresses the individual’s clinical needs, in-home care and lifts the burden off other family members.   
  • Discerning the effect on caregivers
    • Dr. Novello spoke passionately on the importance of community and camaraderie, especially among physicians and other caregivers. “Doctors who are lonely and overworked, this is what we call ‘physician burnout’ today.” She stated being alone is not the same as being lonely and that we need to make sure today’s clinical leaders are also taking care of themselves.
    • Dr. Novello also went on to explain the importance of caregivers and how women are taking on childcare and parental care, on average, for 11.5 years of their life. “My question is, if we are taking care of everyone else, who is taking care of us?” Geography and gender are the biggest indicators of who is taking on the most caregiver responsibilities and Dr. Novello encouraged women to speak up and not continue as the silent minority.
  • The cost of loneliness
    • “Loneliness is now an epidemic,” Dr. Shrank said. “Fifty percent of women 75 and older live alone and we’re seeing more evidence that socially isolated individuals have worse health outcomes and higher health care costs. What can we do as a society for the inevitable health decline of Americans and the impact on the person who is sick, but also the family, the caregiver and the folks who wrap around and love that person?” This paints a powerful picture on the work that needs to be done and the opportunity the industry has to make aging in America a more graceful process for individuals and those who surround them every day.

Overall, the session reinforced Humana’s dedication to helping the industry move toward an integrated care delivery structure, including addressing social determinants of health, which may include sending physicians into members’ homes to witness firsthand the living environment that can impact the member’s health. 

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Reducing waste in the U.S. health care system can lower costs and allow resources to be allocated to areas of care that need it most, said Dr. William Shrank, Humana’s Chief Medical and Corporate Affairs Officer.

Dr. Shrank recently wrote an opinion piece that was published in Morning Consult.

You can read it here.

He referenced a recent study conducted by Humana and the University of Pittsburgh School of Medicine, which found that approximately 25 percent of all U.S. health care spending, or $760 billion to $935 billion, can be classified as waste.

He noted that waste could be reduced by reducing administrative complexity, addressing pricing failures, and implementing effective clinical models.

“By leveraging value-based payment models (aligning reimbursements for providers to reward higher-quality care, better outcomes and lower costs, rather than simply rewarding doctors for the number of services they offer) that align the interests of health plans and clinicians, we should be able to massively reduce this complexity,” he wrote. “Moreover, the Centers for Medicare and Medicaid Services and the industry are building momentum to deliver the data interoperability that will reduce administrative complexity, which will help rein in costs.”

On pricing, he noted: “Efforts to advocate for policies that promote greater competition in the marketplace and price transparency for patients should drive considerable savings. As we have seen with the Medicare Advantage program, competition reduces costs and improves patient health outcomes.”

He also said, “Evidence shows us that scaling effective clinical strategies and programs across the country can help achieve these savings — for example, providing care coordination, health coaching and proactive outreach to patients with diabetes or congestive heart failure.”

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Dr. William Shrank, Humana’s Chief Medical and Corporate Affairs Officer, recently spoke with Home Health Care News about “social determinants of health, continuing health care trends and the ongoing alignment of the company’s in-home care operations.”

“We’re increasingly acknowledging and realizing the importance of social context in the health of our members,” he said. “We’re increasingly thinking about whole-person health and how to manage not only the physical health issues or the behavioral health of our members but how to couch it within the social context in which they live.

“We want to better understand the social barriers that influence their ability to achieve their best health. When you put all those things together — with the fact that more complex seniors are living at home and prefer to be cared for at home with personalized health care services — you can see why we’re driven to leverage all of these in-home pieces.

The article noted that Humana “is busy with its many in-home endeavors, which include Humana At Home, Curo Health Services and Kindred at Home.”

“I think one thing that I would want to continually reiterate is that we do not treat physical disease — we treat people,” Dr. Shrank said. “We do not treat behavioral health — we treat people. And you can’t treat a part without looking at the whole.”

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