Humana 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 food insecurity.
The value of Medicare Advantage
Bruce 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:
- Taking 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.”
- He 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.
- The 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 health
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 her medications.
“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 member.”
“That’s 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 an individual.”
Integration is essential for this holistic approach to care
Bruce 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 overall.”
Humana 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 goes away.”
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.