Humana CEO Bruce Broussard

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 – Let’s seize health care’s great opportunity – is reprinted below. To see all of his blog posts, click here.

Each of us has experienced firsthand the complexity of our health care system, and we know how confusing and complicated it can be just to manage our own health records. We get it. We empathize with you. It needs to change.

I’ve heard from many of you that managing your health records should be as easy as managing your 401(k) account on your phone. Across the world, there is a growing movement to give consumers control over their data. Health data should be no different. Patients need to control their health data, and they need easy access to it.

There’s good news on the horizon. The health care industry is working to give patients, physicians, clinicians and health plans the ability to access and securely share clinical patient information in near real-time. This is the concept known as interoperability, which connects data across the health care system and allows patients to better manage their health and make informed care decisions.

While 86 percent of office-based physicians are using electronic medical records, many health systems cannot share these with each other, resulting in vast, isolated silos of critical patient information. However, if these systems could begin to talk to one another, we could improve care coordination and generate “more than $30 billion in annual health care savings.”

Interoperability gives health care consumers what they rightly deserve – ownership of their health information. Today, physicians, patients and health plans have a hard time sharing patient information. You experience this when you visit the doctor’s office and fill out personal-information forms – again – or urge them to send your information to another physician.

You might not realize this, but some companies that collect patient data are using proprietary systems and charging exorbitant fees to connect to other systems. These outdated business models profit from the sale of patient medical data at the expense of consumers having access to their own health data.

Despite these challenges, I’m optimistic about our industry’s ability to come together and embrace interoperability so we can bring much-needed simplicity to the system, which will improve care and lower costs.

We have a bold call to action to achieve interoperability. The Centers for Medicare and Medicaid Services (CMS) has issued an important call to action that will empower consumers to control, access and share their personal health data while also making it easier for physicians to share data with other physicians treating the same patients.
Dubbed the Interoperability and Patient Access proposed rule, the goal is to “break down barriers to interoperability and health information exchange,” leveraging the progress of the Blue Button initiative.

CMS intends to require health plans like Humana to implement Fast Healthcare Interoperability (FHIR)-based application program interfaces (APIs) to enable patients to share their lab results, health claims, prescriptions and other clinical information with their physicians via the click of a button on a mobile device. These APIs make it easier for patients, clinicians and health plans to access and share critical health information.

Medicare Advantage enrollees can certainly benefit from interoperability. Today, nearly 75 percent of people over the age of 65 are living with multiple chronic conditions, and these conditions account for the majority of what we spend on health care. Interoperability could improve these people’s health.

Physicians treating patients with multiple chronic conditions would have a near real-time, holistic view of all the clinical actions performed by his or her peers. From reducing redundant testing to stopping conflicting prescriptions, these physicians could leverage this holistic patient data to make more-informed decisions.

The CMS proposal puts seniors in control of their own data, enabling them to decide who gets their information and empowering them to better manage their health. Health plans like Humana that administer Medicare Advantage also benefit from interoperability because it augments the holistic approach to care by using data analytics to garner and share insights from the patient’s data. That helps physicians and clinicians improve people’s health and well-being.

The health care industry has a great opportunity to band together to answer CMS’ call to help deliver a new patient experience. The promise of interoperability is inspiring because, if done right, it will be the foundation for transforming the system.

Physicians should have the best information available, and no one should have to spend hours tracking their health records. I empathize with anyone who has had a difficult experience.

The time for change is now. Let’s heed the call.

Let’s seize health care’s great opportunity

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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 — I aspire to deliver “life-changing” care— is reprinted below. To see all of his blog posts, click here.

Bruce Broussard

In many of my previous blogs, I have discussed the importance of lifestyle on health outcomes. Historically, our health care system has been oriented toward episodic treatments, and we have seen significant advancement in science allowing more effective treatments for complicated conditions, like cancer, Hepatitis C and severe cardiovascular disorders. These treatments are extending life; however, without assisting patients with their lifestyle needs, the advancement in science will be diluted. This is especially true in population segments that are more impacted by social determinants of health.

I am excited to see the increasing sophistication of health care policy that’s encouraging the integration of social determinants into health care.  Recently, CMS has taken two large steps in the integration, including: 1) the interoperability of health care information through their recent efforts in Blue Button and the Interoperability and Patient Access Proposed Rule and 2) the addition of new supplemental benefits within Medicare Advantage (MA). 

For example, MA organizations like ours can expand offering services such as transportation for non-medical needs, home-delivered meals, fresh produce, and social benefits that address isolation. Some of these new plans will offer better rewards and incentive programs, more accessible telehealth services and – ultimately – better wellness and care planning.

In this more favorable landscape for supplemental benefits, MA plans can better tailor offerings, address gaps in care, and improve health outcomes for the chronically ill. We’re excited to see such fresh creativity in benefit design as it will make it easier to help members like “John.”

Care needs to go beyond the clinical.

John is a Humana Medicare Advantage member in his late sixties. Medicare Advantage, the private form of Medicare that John has chosen for his health care, helps seniors address their health and non-health challenges so they can focus on living the lives they want. Medicare Advantage takes a comprehensive, holistic approach to help seniors like John slow the progression of chronic diseases like diabetes.

John had a high A1C, and he wasn’t going to his appointments, increasing his chance of vision loss, a heart attack or a stroke. Our Partners in Primary Care (PiPC) clinicians proactively contacted John and found that he could not afford the $15 copay for his office visit, he couldn’t buy healthy foods, and he couldn’t cover his portion of prescription costs.

The good news for John is that his Medicare Advantage program wasn’t just designed to address the clinical aspects of his care. Through personalized interactions, his plan also revealed his lifestyle needs, which contribute greatly to overall health and well-being. The PiPC clinician team helped him fill out a Supplemental Nutrition Assistance Program (SNAP) application, and he was preapproved for up to $165 in benefits. The PiPC team also helped John get the power company to lower his monthly bill because of his low income.

At Humana, we’re privileged to help our physician and clinician teams like PiPC and others deliver quality care to people like John in the most appropriate/most preferred setting, whether it’s in the doctor’s office or his home. This teamwork helps support a comprehensive, empathetic approach that removes these barriers to better health.

I was humbled to hear John say this type of support has been “life-changing” for him.

We’re working together to build a connected system to remove barriers to health.

In addition to being able to offer more services and benefits through the Medicare Advantage program, technology is playing a key role in creating an interconnected system, helping consumers use their own smart phones and tablets to manage their health care data.

Interoperability—where information systems are connected and coordinated—is freeing up data and providing a real-time, holistic view of each patient’s health. Put simply, the free flow of data makes it easier for everyone involved to deliver the right care at the right time and in the most appropriate setting.

That’s key for seniors, because they’re often living with multiple chronic conditions and need help removing barriers to their health.

Let’s keep helping John and others improve their health and save money.

Seniors like John who participate in Medicare Advantage are spending less time in the ER and have fewer hospital stays than those with traditional Medicare, and their medical costs have been shown to be 15.6 percent lower.

There’s an atmosphere of optimism in health care around what’s possible, and the changes taking place today are certainly moving the industry in the right direction, with the ultimate goal being to help people like John live happy and healthier lives. 

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