The Commonwealth Fund, a nonprofit private foundation supporting
independent research on health policy reform and a high-performance health
system, recently reported on the CHRONIC Care Act, which passed in 2018 and
made it possible “for Medicare
Advantage plans to begin covering services like adult day care, support for
family caregivers, pest control, or other benefits that help members maintain
or improve their health.”
The story cited Humana’s Bold Goal:
“In 2015, Humana launched the Bold
Goal initiative, an effort to improve members’ health 20 percent by 2020 and
beyond by identifying the social determinants of poor health and partnering
with community organizations to address them. The insurer is working in 14
markets, where thus far some 1 million members have been screened. About 15
percent of Medicare Advantage plan members reported being food insecure and
about 37 percent report being socially isolated — both factors that put people
at increased risk of getting sick and accruing higher medical spending.
Andrew Renda, M.D., Humana’s associate
vice president for population health, was quoted, saying, “When you have
someone with a chronic condition and put social needs on top there’s an
exponential increase in cost. That’s the perfect storm we’re trying to avoid.”
The story also cited Humana’s efforts
in Tampa, where lonely seniors can utilize “grandkids-on-demand;” programs in Kansas
City and Knoxville, in partnership with Walgreens, to screen thousands of
people for food insecurity; and toolkits to help clinicians identify and
address food insecurity.
The story also noted that, “this year, Humana will introduce grocery
benefits for 50,000 members in its Medicare Advantage Special Needs Plans (for
people eligible for both Medicare and Medicaid).”
President and CEO Bruce Broussard recently spoke at the 2019 Forbes Healthcare Summit, where he
participated in a panel discussion titled “Supercharging the Medicare Advantage Experience.”
Bruce and other panel participants discussed how Medicare
Advantage plans are evolving to address social determinants of health, such as
The value of Medicare Advantage
Japsen, Senior Healthcare Contributor, Forbes, who moderated the
panel, began by asking Bruce about Medicare Advantage. Bruce spoke to three key
elements that make it impactful:
full risk for a population. Bruce talked about how health plans are paid a fixed
fee but are “responsible for overall population. That gives us a lot of freedom
on what we can do.”
said “the consumer decides (their health plan selection), as opposed to the HR
department or some other individual that is not the user.” The industry must
compete to serve the customer, which drives innovation.
third element “which is really unique is you get paid more for taking care of
sick people, which is not an insurance model…It’s an upside down insurance
model.” Bruce added that this gives Humana the freedom in what we can do to
improve people’s health.
People need a purpose to improve their
During the panel, Bruce also spoke about how people
are motivated to change their health when they find purpose. He talked about Jo, a Humana Medicare Advantage member living with
multiple chronic conditions. She is also responsible for taking care of her
adult son, who is mentally disabled.
Bruce credits the Humana nurse – Vicki – with
getting Jo engaged in her care after having a stroke and being hospitalized. Jo stopped smoking and started doing breathing
exercises, and Humana helped her find financial assistance so she could afford
“Vicki didn’t say, ‘You’re a diabetic and you need
to do these things and that smoking was bad for her.’ What she found was this
motivator…She was a caregiver for her son that was mentally ill. Vicki began
the conversation around let’s be able to walk with John today. That began to
start having the engagement around a purpose of why she should do this as
opposed to the health care system saying that she should do it. It was much
around what is personal for her and what motivates her.”
Bruce said Jo’s story is “the beauty of the
(Medicare Advantage) model. It’s not about just getting paid for doing a
treatment; we get paid for outcomes. And those outcomes allow us to have both
these broad services, but motivation and innovation to help engage with the
not a fee-for-service environment. Medicare Advantage encourages organizations
like ours to wrap services around them. That’s why you see us acquiring and
building these capabilities and services, being able to wrap those around and
have a holistic view, as opposed to just treating a particular circumstance of
Integration is essential for this holistic
approach to care
also spoke about the need to take a holistic view of an individual, incorporating
lifestyle with social determinants of health, primary care, home health and
behavioral health, and doing so in the “the best way that helps the individual
and the industry are part of a movement to “integrate the insurance to the
health care services side.” He said, “We find that that integration allows a
much smoother way to manage the population health orientation, but then you
also are able to integrate it and make it much easier for the individual to use
it, as opposed to there’s a treatment, we get something fixed, and the person
Brenda Schmidt, Founder & Chief Executive Officer,
Solera Health; and Felicia F. Norwood, Executive Vice
President and President, Government Business Division, Anthem, Inc., were the
other two panel participants.
For more information on Humana’s Medicare
Advantage efforts, click here to check out the company’s annual Value-based
Care report, which was issued last month.
Humana announced today that it is launching the Humana Honor Medicare Advantage plans for 2020. ‘Honor’ underscores Humana’s commitment to veterans and is designed to complement health care provided through Veterans Affairs (VA). Humana Honor also boosts Humana’s Medicare Advantage slate of plans that are available to all Medicare-eligible individuals, which offer affordable health benefits and wellness programs with added convenience and a holistic focus on health and well-being for veterans and their families. Humana Honor Plans are available to anyone eligible for Medicare, but are designed in a way that may complement the benefits a veteran receives through VA Healthcare.
Highlights of Humana Honor Medicare Advantage plans for 2020:
All plans are $0 premium, and all but one offer a Part B giveback (premium reduction).
Enrolling in Humana Honor may augment VA coverage and help close any gaps in health care coverage.
Humana Honor may provide Medicare-eligible veterans with additional health care services and location options.
Humana Honor will give veterans access to robust dental coverage.
Humana Honor plans offer a broad network, including Urgent Care access.
Humana’s coordinated effort in creating Medicare Advantage plans that enhance options for veterans is an important milestone in helping veterans overcome barriers to achieving their best health.
“The launch of Humana Honor is a natural next step in our commitment to veterans and their families,” said Alan Wheatley, president, Retail Segment at Humana. “Considering care options from multiple sources can be confusing, and we understand that veteran health goes beyond physical symptoms – it’s a state of general well-being that encompasses a healthy body and mind – and our 2020 Humana Honor plans reinforce our ongoing commitment to support the total care our veterans need, not just in the doctor’s office.”
Humana Honor consists of 17 plans, available in 28 states including; Alabama, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nevada, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah and Washington.
Humana has served Medicare beneficiaries for more than three decades, with 8.4 million Medicare members in all 50 states, Washington, D.C. and Puerto Rico, as of June 30, 2019. Slightly over 4 million of those members are enrolled in a Medicare Advantage plan, which often provides them with extra coverage, such as prescription drug coverage and dental, hearing and vision benefits.
Humana has a longstanding relationship with the military community, and is committed to the well-being of all veterans and their families. Since 2012, Humana has built strong national relationships with the Veterans of Foreign Wars (VFW) and American Veterans (AMVETS). Through a partnership with the VFW’s Uniting to Combat Hunger campaign, Humana has helped to raise over 500,000 meals for veterans and communities. The VFW and AMVETS have selected Humana as their national MA/MedSupp/PDP provider1. VFW and AMVETs members are able to select any MA plan, including a Humana Honor plan offered in their respective areas.
Humana Military was awarded the TRICARE East Region contract that covers more than 5.9 million lives across a 30-state region. This is the largest TRICARE contract to date, and it took effect January 1, 2018.
For More Information
For more information about Humana’s 2020 Medicare offerings, visit www.Humana.com/Medicare or call toll-free 1-800-457-4708 (TTY: 711). Licensed sales agents are available 8 a.m. to 8 p.m. local time, seven days a week.
1 These agreements do not establish any group health plan nor do the agreements obligate any individual VFW or AMVET members to purchase a Humana MA, PDP, or Medicare Supplement product.
Humana is hiring hundreds of employees in De Pere, Wisconsin;
Louisville, Kentucky; Glendale, Arizona; and Springdale, Ohio. The Kentucky team
needs employees to support open enrollment for Medicare, which begins October
15. In Wisconsin, customer service representatives will provide telephone
support to members. The Arizona
and Ohio teams are looking to add pharmacy technicians.
In Louisville, Humana is looking for part-time and full-time
enrollment representatives to process Humana Medicare Advantage member
applications. Enrollment representatives will review reports and make
adjustments, additions and deletions based on Center for Medicare and Medicaid
Services (CMS) regulations respond to inquiries, and reconcile enrollment
application information before they are entered in Humana’s member enrollment
systems. These employees will be based in downtown Louisville and will serve
for six months or less during the open enrollment season. These professionals
need to be detail-oriented with strong computer skills and an ability to
practice strict confidentiality for all sensitive information. A variety of
part-time work schedules are available, including 7-11 a.m.; 9 a.m.-1 p.m.; 10
a.m.-2 p.m. and 1-5 p.m. Overtime is available, but not mandatory.
Interested candidates can apply in person at a Humana career
event on Saturday, September 7 from 8 a.m. to 2 p.m. at 1325 S. Hurstbourne
Parkway in Louisville.
The Humana team in De Pere, Wisconsin is looking for people
to provide telephone support to Humana Medicare Advantage members, which may include answering plan and benefit questions.
The successful candidate will have a high school diploma or GED, and previous customer
service-related experience is preferred.
Humana is conducting interviews at an open house on
Saturday, September 21 from 8 a.m. to 4:30 p.m. at Humana’s De Pere office at
1100 Employers Blvd.
Pharmacy technicians are needed for the Glendale, Arizona
and Springdale, Ohio Humana Pharmacy teams. These roles may be taking calls
from Humana members, resolving matters related to mail-order pharmacy, making
outbound calls to doctors’ offices or Humana members, dispensing/filling
prescriptions, or performing data entry of prescriptions. In Ohio, there is a
career fair to learn more and apply on Friday, September 13 from 3 to 7 p.m.
and Saturday, September 14 from 9 a.m. to 2 p.m. at 111 Merchant Street in
Springdale. In Arizona, the career fair is Wednesday, September 18 from noon to
5 p.m. and Thursday, September 19 from 9 a.m. to 2 p.m. at 8990 W. Glendale
Avenue in Glendale.
For all the career events, it is recommended that candidates
dress professionally for an interview and bring several copies of a current
resume. Humana offers competitive hourly pay, benefits, and a bonus/incentive
program, all of which start on the first day of employment.
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.
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.