senior health

The lack of funding and support to alleviate the social determinants of health (loneliness, food insecurity, lack of transportation) are making it very difficult, especially for seniors living with multiple chronic conditions, to improve their health. In a blog post for the World Economic Forum, Humana President and CEO Bruce Broussard examines what the U.S. health care system can do to better address the challenge.

Read the blog here.

 

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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 — What does 2019 look like for health care? — is reprinted below. To see all of his blog posts, click here.

In the current environment, constant and negative debate over health care makes it easy for us to be down on our industry. But I’m excited about health care’s potential, and I’m proud of the progress we’ve made.

I believe we are at the pivot point of greatly improving health care. More people are being treated under reimbursement models – like Medicare Advantage – that incent complete health, not just the delivery of care. In addition, advancements in digital technologies – such as home-based monitoring devices and personalized science – are increasing the opportunity to leverage the growing sophistication of analytics, artificial intelligence, natural language processing, and machine learning.

Progress today and on the horizon

I’ve seen promising advancements in interoperability, which is empowering patients and resulting in better care. Interoperability gives doctors and other clinicians a complete view of the patient’s medical history, which increases the personalization and timeliness of care interventions.

We have been critical of electronic medical records, but EMRs have digitized millions of paper medical records, increasing the velocity and volume of information and allowing for more complete and timely decisions.

I see parallels in the history of banking. Interconnecting and digitizing bank transactions – and implementing interstate banking laws — permanently changed the banking structure, creating a more convenient and cheaper system. An example is how stock trades decreased from $75 to $.05 per trade. In health care, that degree of cost reduction would greatly expand the affordability of care and significantly reduce our federal and state deficits.

As I’ve written before, the Centers for Medicare and Medicaid Services (CMS) has challenged the health care industry through the Blue Button initiative, which was designed to drive the necessary, useful interoperability to enable all physicians and all consumers to manage their health online, like they do with their bank accounts and investments.

Patient information needs to be shared, and we can’t encourage business models that impede the process. The good news is we’re moving in the right direction.

Experiencing it myself

For the last few months, I’ve experienced the future of interoperability firsthand by using my Apple Health Kit to download my own health data to my iPhone. Thanks to FHIR, which helps enable this process, I can easily view my patient information — from annual checkups to data such as blood pressure, weight and BMI.

Apple Health Records was launched just 11 months ago, and the company has been the first to gain traction on the EMR. Imagine what will happen when more iPhone users like me do this and the 100 million Android users in the U.S. catch on.

Such data doesn’t just help patients; it’s helping the physicians who care for them. At Humana, we’ve asked our 3.5 million Medicare Advantage members for permission to access their Medicare information – scripts, doctor visits, etc. We can then use this information to design and price health products specifically for them.

Data sharing, fueled by true interoperability, will stimulate innovation. Yet for adoption to increase, our industry must ensure that the experience is on par with online shopping, travel and financial experiences. In health care, this might show up as a primary care physician having real-time access to a list of all the drugs a patient is taking. That’s especially important in treating seniors, many of whom are living with multiple chronic conditions.

So what’s in store for 2019?

More companies will access data to create consumer-engaged business models that encourage competition, foster innovation, and, ultimately, disrupt and force our industry to evolve. We’ll see new and innovative products that help people with their health.

Successful innovations won’t be siloed; interoperability will help physicians make decisions supported by analytics. But technology will only take this so far. It’s up to physician and clinician offices, health plans, and government to help consumers have a real-time, detailed understanding of their health. Physicians, too, will have a truly holistic view of their patients.

Let’s continue to construct a competitive system that fosters a climate of innovation. In the end, we’ll make it easier for physicians to help their patients and for patients to help themselves.

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Humana’s value-based care report has shown how physician practices in value-based agreements are increasing preventive care, improving health outcomes and quality measures, and lowering overall health care costs for Humana Medicare Advantage (MA) members.

This video features a panel discussion of care professionals discussing the report.

Written by physicians, the report details the clinical and economic impact of integrated care delivery, examining patient care and the experience of physicians. The report, which can be accessed here, also details physician progress controlling blood sugar, blood pressure and medication adherence for people with diabetes.

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Forbes has taken note of Humana’s latest Value-Based Care Report, writing about how the shift from fee-for-service medicine to value-based payments for physicians is reducing costs and improving quality of care for seniors in Medicare Advantage plans.

Read the Forbes article here.

“Medical costs were nearly 16% lower for seniors enrolled in Humana Medicare Advantage plans that paid physicians via value-based models in 2017 compared to costs of those in traditional fee-for service Medicare,” Forbes said, citing the study.

“In the value-based approach, insurers reimburse providers for services plus additional pay if they meet quality measures, control costs and improve health outcomes of their patients. The traditional fee-for-service system pays for the volume of care delivered.”

The article quoted Dr. Laura Trunk, Humana medical director of provider development, who wrote in the report: “While we know that all physicians are committed to patient health, those in value-based care agreements have access to additional resources and capabilities to build the infrastructure they need to expand their reach outside the practice. Focusing on prevention and the whole health of their panel population allows physicians and their care teams to work more strategically to improve the care of their patients, thus keeping them home and out of the hospital and emergency room.”

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