In this progress report - Let`s Close the Gap

Transcription

In this progress report - Let`s Close the Gap
Humana 2020
2015 progress report
Our commitment
to serve
Bruce Broussard
Humana’s President and
Chief Executive Officer
Several years ago Humana broke new
ground when we announced that, as a
health enterprise, we would be guided
not by a mission statement or a vision
statement – but by a dream. Our dream
is to help people achieve lifelong wellbeing. This has motivated, inspired, and
engaged our 57,000 associates when
they come to work at Humana every day.
Even more importantly, it has resulted in
measurable health improvement for many
of our 14 million medical members across
the country.
Over time, we came to realize that, though
powerful, our dream is not enough. In
order to achieve it, we understood we
would have to measure it – to make it
“a dream with a deadline.” Today, we are
making public the bold goal we have set
for ourselves: To improve the health of
the communities we serve 20 percent
by 2020 by making it easy for people to
achieve their best health.
Why do we put such emphasis on “making
it easy”? Because as a society, we have
made health hard. Our convenience culture
(fast food, sedentary entertainment)
has created barriers to good health that
must be overcome if we’re to achieve
our bold goal. These include a wasteful,
inefficient health care system that rewards
procedures performed rather than health
outcomes achieved; lack of affordable
access to care; fragmented care delivery;
lack of technological interoperability;
communities and environments that make
healthy eating and exercise challenging;
and insufficient engagement by individuals
when it comes to taking responsibility for
their own health improvement.
Humana is dedicated to closing this gap
that has developed between people and
care. Our goal holds us accountable for
doing so. This report is the first in a series
of updates that will periodically describe
how we’re doing.
In this report, you’ll see examples of
where we’ve already made progress
in making health easier, particularly
among Humana associates. You’ll hear
of inspiring partnerships we’re building
in places like San Antonio, Texas and
Natchez, Mississippi, where entire
communities are becoming focused
on the goal of measurable health
improvement. And you’ll read about
how we’re using the “Healthy Days”
measure – developed by the Centers for
Disease Control and Prevention (CDC) – to
track and measure our overall progress.
We invite you to keep up with us and our
partners over the next six years as we
strive to bring healthy, positive change
to the communities and people we serve.
Our goal:
The communities we serve will be 20% healthier
by 2020 because we make it easy for people
to achieve their best health
2
Our approach
Integrated Care Delivery Model
So, where do we start with our goal of
improving the health of the communities
we serve 20 percent by 2020?
It starts with our strategy: offering
Humana health plan members access to
quality, affordable health care services
through a consistent, best-in-class consumer
experience. Our Integrated Care Delivery
Model is the engine of this strategy, which
uses sophisticated data analytics to provide
effective, seamless, personalized care with
high member engagement.
What does this look like in action? Take
Humana At HomeSM, a program where we
send care managers into the homes of
members who have multiple chronic
conditions to develop a more holistic
approach to their health. This model is
very effective for members who are
managing chronic conditions like severe
diabetes or congestive heart failure, which
require adopting new regimens around
medications, diet and other changes in
We not only
prescribe this
approach...
we live it.
Best Employers
for Healthy
Lifestyles
Platinum, 2014
National Business Group on Health
daily living. The care enables us to help
our members not only maintain their
quality of life but also remain independent
in their homes.
Integrated Care Delivery Model
This holistic approach to member-centered
care is also reflected at our Clínica
Asociación Cubana (CAC) Florida Medical
Centers, where our geriatrics experts
provide routine medical and ancillary care
services “under one roof,” all orchestrated
by primary care physicians.
CAC and Humana At Home are proven ways
that Humana is making it easy for people to
achieve their best health. It’s the future of
care, available today.
To ensure our approach is effective, we
have to measure it, thus measurement
is an important element of achieving the
goal. We’re using a proven instrument
developed specifically for population health
management known as “Healthy Days.”
Developed by the Centers for Disease
Control and Prevention (CDC), the measure
asks people to self-rate their health as well
as recent days of physical health, mental
health, and activity limitation. We believe
Healthy Days is a good measure of the
effectiveness of our Integrated Care Delivery
Model and we explain the measure in great
detail later in this report.
Our vision is a health care system that
revolves around individuals and their
primary care physicians, the essential
foundation for achieving our bold goal.
For too long, both people and the health
care system itself have suffered from an
emphasis on sickness rather than health.
Humana is working to change that and
measure the change as we go.
The role that technology
plays during this
transformational moment for
Humana and our members
is intricately related to the
ultimate success of our
journey toward becoming
a consumer-focused health
and well-being company and
achieving our bold goal. With
an integrated technology
strategy that encompasses
the macro trends of mobile,
social, cloud and analytics,
we’re better able to reach
and understand our
customers, and provide
them the tools they want
and need, ultimately
enabling people to make
better decisions and create
better health outcomes.
– Brian LeClaire
Humana’s Chief Information Officer
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3
5 key points
of influence
As one of America’s leading health
and well-being companies, Humana
has the reach and the resources
to simplify the health care system
and better support the way physicians,
clinicians and other health professionals
deliver care. As we pursue our bold
goal we’ve identified five key points of
influence where our integrated approach
to care has the most impact on improving
people’s health:
Wellness and
Prevention
Programs like HumanaVitality® –
an incentive-based wellness rewards
program with more than 3.8 million
members, including many Humana
associates – provide education, resources
and coaching for people to make better
daily choices that can improve their physical
and mental health today and in the future.
HumanaVitality knows that to effectively
motivate individuals to achieve healthier
actions, wellness programs have to work
hand-in-hand with members, leading
them through the process of understanding
their health status, choosing improvement
or maintenance goals, staying motivated
and relying on verifiable data to reward
their accomplishments. From 2012 to 2014,
Humana associates who enrolled in Vitality
had lower health costs and fewer work
absences than those who didn’t.
Primary Care
Health care relationships between
physicians and their patients are
critically important. Physicians
know their patients’ health. As more and
more people in the U.S. struggle with
chronic conditions that require ongoing care
management, these relationships are more
critical than ever. That’s why we’re increasing
our investment in primary care delivery.
Humana has relationships with more than
42,000 primary care providers either directly
employed by the company or working
with Humana through contracts and joint
ventures. We’re making it easier to connect
these doctors with their patients.
Pharmacy
Humana Pharmacy Solutions®
provides affordable medications
to our health plan members. We want to
ensure our members get the prescriptions
4
62%
of our new
Medicare Advantage
members for 2014
had wellness
screenings
via a Health Risk
Assessment
they need when they need them. Our
research shows Humana Pharmacy
Solutions customers take their medications
as prescribed at a higher rate and have lower
out-of-pocket costs than customers who
obtain their prescriptions in retail locations.
Last year we processed approximately
330 million prescriptions; we dispensed
about 30 million of these prescriptions.
Home Health
People who face the greatest
health care challenges need a
comprehensive, full-service approach. That’s
why Humana offers in-home care, telephonic
health counseling/coaching, and remote
monitoring, among other programs. A recent
two-year study showed that, on average, our
Medicare Advantage members enrolled with
Humana At Home lived longer than those
who were not enrolled.
496,000
more days
at home
for newly managed
Humana Chronic Care
Program members
By addressing the scope of
needs of people living with
chronic health conditions,
including help with daily
activities, we are making
a profound impact on
their quality of life and
enabling them to remain
independent at home.
– Eric Rackow, M.D.
“Humana At Home” Leader
Informatics
One of Humana’s highest priorities
is to harness the power of data
and analytics to improve the health of
Americans and the system that cares for
them. Humana’s analytics operations
review millions of clinical data points each
day. Using social media, smartphone
apps and other tools, Humana provides
members, health care providers and health
care companies real-time clinical insights
to address gaps in care, improve health
outcomes and reduce costs. In 2014,
Humana used its data analytics capabilities
to detect 4.3 million instances where
necessary care (for example, an eye exam
for a person with diabetes) had not been
given; we alerted members and their
physicians and followed up until the gaps
were closed. In addition, we also identified
1.9 million high-risk members through
predictive models.
92%
of Humana Medicare
Advantage members
are covered by a
health plan that has a
Stars Quality
rating of 4.0
or higher
*Centers for Medicare and Medicaid Services
Quality Rating System
How we’re improving care
Population health
To improve the health of the people and
communities we serve, Humana is focused
on helping physicians drive improved health
outcomes for all of their patients. This
“population health” approach will equip
physicians to succeed in a new health care
environment as the U.S. population ages
and chronic health conditions continue to
challenge our society.
In mid-March, Humana announced the
formation of Transcend™ and Transcend
Insights. Transcend provides resources
in care coordination, financial risk
management, clinical integration and
patient engagement that help physicians
improve the patient experience as well as
care outcomes. Transcend Insights provides
health care systems, physicians and care
teams with advanced Internet-based
interoperability, real-time health care
analytics and intuitive care tools to simplify
the complexities of population health.
Rewarding for results
A key part of Humana’s population health
approach is to help physicians evolve
from health care’s current fee-for-service
payment system to a value-based
system. The traditional, long-standing
fee-for-service model pays physicians for
each activity they perform; it does not
pay them for measurably improving the
health of their patients. Within the fee-forservice system is an inherent conflict: the
more services physicians and other care
professionals provide to their patients, the
more they are paid. Fee-for-service does
not reward physicians for helping their
patients achieve their best health.
As a result, people sometimes receive care
they don’t need. Additionally, ongoing
primary care management for people
with chronic conditions often receives
insufficient emphasis and attention.
Humana and others have begun to
implement a solution to this problem: a
value-based model that promotes highquality care based on what research and
studies have shown to be most effective
in improving health. Already in wide use
in the Medicare Advantage program,
our approach to value-based physician
payments, sometimes called accountable
care, has helped more than 1.3 million of
our Medicare Advantage members get on
the path to better health. At Humana, part
of integrated care means embracing this
value-based approach to managing our
relationships with care providers.
Trusting partnerships
Humana is partnering with more than
42,000 primary care providers in valuebased arrangements. We’re helping
these physicians and others incorporate
best practices in care management. This
includes provider analytics tools that show
real-time identification of gaps in care while
a patient is present in the physician’s office,
at a clinic or in the hospital. This enables us
to take key steps forward when it comes to
achieving our bold goal.
We’ve still got a long way to go. Humana
expects to have 75 percent of our individual
Medicare Advantage (MA) members
covered under this value-based payments
approach by 2017. Ultimately, this new
paradigm has the potential to transform
the health care system, rewarding doctors,
hospitals, and other providers according to
assessments of how well patients do under
their care.
Researching
to drive change
Humana’s aspiration to revolutionize
American health and American health
care also extends to the field of research.
At Humana, we’re conducting our own
population health studies and partnering
with prestigious academic institutions
and private foundations to contribute to
systemic change.
In the past year, Humana researchers
have presented health research findings
at events sponsored by the American
Public Health Association, the Academy of
Managed Care Pharmacy and the American
Society of Clinical Oncology, among others.
We understand that the transition
from fee-for-service to value-based for
physicians will not come overnight. Our
goal is to offer programs to meet these
physicians where they are in their practices
and support them as they move toward a
value-based approach.
Our results show that
physicians who we’re
partnering with in valuebased arrangements are
getting better quality
scores and better health
results for their patients.
– Roy Beveridge, M.D.
Humana’s Chief Medical Officer
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5
Measuring the health of the
communities we serve
Healthy Days
A consumer-focused
measure of health
Measuring the impact of our Integrated
Care Delivery Model and the health of
communities we seek to make healthier is
a key component of Humana’s bold
goal. It was important for us to identify
a clinically-focused scientific approach
that provides sufficient information, yet
is simple enough to collect the necessary
data and to measure our progress. We
wanted to ensure that we know whether
the people we serve are improving their
health and well-being.
There is no silver bullet or absolute
standard for the measurement of the
health of a community. Health is not simply
the amalgamation of diagnoses made by
a patient’s clinicians. It must also reflect
the patient’s perception and feelings about
their own health.
A cross-functional team of Humana
clinical and analytics leaders along with
national experts from the academic and
public health worlds performed a review
of existing measures of population health,
Measuring the health
of the communities
we serve*
6.7
Physically
unhealthy
days
11
4.3
Mentally
unhealthy
days
unhealthy
days
2020 Goal
improve by 20% to
8.8
unhealthy
days
Goal is a 20%
reduction in average
unhealthy days from
the baseline by the
end of 2020.
6
*Includes Humana members in our Medicare
Advantage, HumanaOne, and Employer Group
Plans. Total sample size of 133,773 respondents.
seeking a measure that was reliable,
actionable, externally recognized, clinically
relevant and simple.
After reviewing the available options,
Humana determined that the Centers
for Disease Control and Prevention (CDC)
instrument known as “Healthy Days” was
the tool that best suited our needs. The
Healthy Days instrument was developed
by the CDC to measure population health.
Healthy Days asks people about general
self-rated health and recent days of
physical health, mental health and
activity limitation.
The Healthy Days instrument includes
a total of four questions. Two of these
questions, which ask about physical and
mental health over the previous 30 days,
are used to derive an index of unhealthy
days that form the Healthy Days measure:
CDC Healthy Days is a simple
survey that is easy for people
to understand and answer,
yet provides a valid summary
health-related quality of life
(HRQoL) measure to assess
how a person perceives her
or his recent physical and
mental health.
– Haomiao Jia, PhD
Associate Professor at Columbia University,
Department of Biostatistics
1. Now thinking about your physical health,
which includes physical illness and injury,
for how many days during the past 30
days was your physical health not good?
2. Now thinking about your mental health,
which includes stress, depression, and
problems with emotions, for how many
days during the past 30 days was your
mental health not good?
Since 1988, the CDC has been asking over
450,000 Americans per year these questions
and tracking the Healthy Days measure.
It has also been used by other population
health experts, including academic thought
leaders and practitioners, such as the
Robert Wood Johnson Foundation and the
University of Wisconsin. The questionnaire
has been shown to deliver reproducible
results, to provide a holistic view of a
person’s health, and to capture perceptions
of health regardless of age, gender, race, or
clinical condition. In addition, self-assessed
health status has been proven to be a
more powerful predictor of mortality and
morbidity than many clinical measures of
health. Two decades of studies, and our
own experience, confirm that the Healthy
Days measure is highly correlated to actual
clinical health.
Measuring our goal
Using the Healthy Days questions, Humana
partnered with population health experts
to develop our survey methodology. To
measure progress against our goal of
making communities 20 percent healthier,
we will survey a statistically valid random
sample of members from our major
medical lines of business where we have
influence over members’ overall health.
This includes members who have Medicare
Advantage plans, plans purchased through
the individual exchanges and plans offered
through employers.
During the fourth quarter of 2014 Humana
conducted surveys to establish Healthy
Days baselines for members in these key
medical lines of business. In addition, we
have established Healthy Days baselines
in geographic communities where
there is significant Humana health plan
membership. We will continue to measure
the health of our communities annually
through 2020 using this methodology,
and our progress toward the goal will be
measured by the reduction in unhealthy
days from the baselines.
It’s important to remember
that every population is
made up of individual
people. That’s why it makes
sense that we ask individual
members of these
communities a version
of the basic questions we
ask anyone we care about:
‘How are you feeling?
How have you been?’
– Jody Bilney
Humana’s Chief Consumer Officer
We know that our bold goal will require us
to learn and innovate. We believe that the
next one to two years will be learning years
where we work with specific populations
to generate new insights and discoveries
on how to improve health. We expect
these learnings will allow us to make great
strides during the latter years of our journey
toward our goal.
Measuring our progress
is essential to achieving
this bold goal. It is how
we quantify our
commitment to our
associates, our members,
and the communities
where they live.
– Lisa Stephens
“Humana 2020” Director, Measurement
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7
Impacting the health
of our communities
Our goal centers on
communities because we
know that good health
depends on access to
healthy foods, safe places to
exercise, and opportunities
to engage in meaningful
activities that inspire us to
keep our healthy habits.
As we’ve begun to work in
key communities with local
leaders, Humana members,
and our associates, we’re
beginning to see the change
we knew was possible.
– Emily Allen Kirby
“Humana 2020” Leader
Beginning our journey
Humana’s bold goal centers around
communities because we recognize that
health care happens in the physician’s
office and in the hospital, but health
happens in the communities in which
we live. The health of individuals is
influenced – for better or worse – every
day by those around us. This is particularly
true in the current era when many of our
country’s health challenges are driven
by chronic conditions – like diabetes
and cardiovascular disease – that
require changes in lifestyle to manage
and improve.
To begin the journey that will take us
to 2020, we have focused energy and
resources on a few key communities. Our
goal in these communities has been to
learn how we can bring our integrated care
model and clinical capabilities and leverage
them in partnership with local leaders and
entities that seek to improve health.
The approach we develop and learning
we generate in any one community can
be used broadly to impact all the
communities Humana serves.
For several years, Humana has been
working with the “community” of
its own associates to improve their
health and well-being. That’s the first
population where we hold ourselves
accountable for demonstrating
improved health outcomes.
In Bell County, KY, we’ve worked for
many years to drive better health
through peer group teams and
have learned much in the process.
We want to invest in our
teammates – we’re better
able to serve other people
when we do that.
– Tim Huval
Humana’s Chief Human Resources Officer
Mississippi is a new community of focus
for us, and over the past year we
launched significant activity there with
the Bill, Hillary and Chelsea Clinton
Foundation. A third community is San
Antonio, where Humana has over
500,000 health plan members and
believes that with the support of the
city’s leadership we can change the
trajectory of health.
Our work in these communities allows
us to address health both in physicianled settings as well as community-based
settings, and it is teaching us what
it takes to make communities healthier.
What makes
us healthy*
50 %
8
healthy
behaviors
20 % environment
20 % genetics
10% access to care
What we
spend on
being healthy*
88% medical
services
4%
8%
healthy
behaviors
other
*Bipartisan Policy Center
Our associate
community
A powerful transformation in how Humana
associates live and do business together
continues to gain momentum. Since
our founding 54 years ago, the heart of
Humana has been about taking care of
people, and today we’re in the midst of a
multi-year journey to achieve our own best
health and well-being. It’s a journey that is
coming to life as a vibrant social movement
that can be described simply as: “be the
best me and be the best we.”
As a community, our associates are
united in their focus on the power of health,
and we understand that physical health
alone is but one aspect of our journey
together – health and well-being are
also about how we feel. We believe that
well-being is holistic, so better health also
comes from the comfort of security, the
excitement of purpose, and the confidence
of heartfelt belonging.
It’s about living happy and living healthy.
Taking better care of ourselves – physically
and emotionally – is one meaningful way
we advance toward the organization’s bold
goal. We understand that it not only has an
impact on us as an associate population,
but it also makes us better able to serve
the communities of Humana members
and patients we care for. That’s why we
have committed to lead the way with our
associate community so that we ourselves
are 20 percent healthier by 2017.
Living happier and healthier can be
hard, but at Humana we’re doing it.
As a community, our associates
reversed the trend toward declining
health by taking action, making better
choices, and improving our sense of
purpose and belonging.
When we look at insights from our recent
study of associates employed since 2012,
the results* are powerful:
• Four out of ten associates have
decreased their number of health risks
closely linked to the development of
chronic disease and another three out
of ten have sustained their levels.
• Overall, the number of average health
risks per associates has decreased
8 percent since 2012.
• Associates who started exercising
regularly reduced their health risks
by 16 percent.
• Among associates with diabetes,
those who developed a higher
sense of belonging were less likely
to develop complications.
Our journey with our associate community
has reinforced the notion that health
happens where we live, work, learn, and
play. It happens when we’re connected to
the people, the reasons, and the care that
are meaningful to us.
While I try to do all the right
things throughout the year, I
find the daily demands of work
and home often overshadow the
common sense of maintaining
mind, spirit and body. The 100
Day Dash actually gives me the
right push to get me refocused
on walking and running. Truth be
told, I look forward to the Dash
because it reminds me of my
commitment to take action on
my biometric results.
– Jim Koeppel
Humana Clinical Care Services Director
194,000
pounds lost
It’s evident we’re taking
better care of ourselves,
but we’re also caring about
each other. The reason
seven out of ten of us
have either improved or
maintained our health over
the past two years is a
combination of positive
lifestyle changes and
vibrant social support
within our community.
by Humana
associates who
improved their health
– Tim State
Humana’s Associate Health and
Well-being Leader
9
*Results represent Humana Health Plan data
through December, 2014.
9
Bell County, Kentucky
Some 200 miles southeast of Humana’s
headquarters in Louisville, Bell County,
KY, has among the highest obesity and
diabetes rates in the nation. But over the
past three years, through a cooperative
program known as Team Up 4 Health,
Humana and the non-profit organization
Microclinic International have reduced
these rates appreciably in a pilot group of
local residents.
The Team Up 4 Health program
emphasizes the power of making small
behavior changes to achieve better health
and well-being. Peer-to-peer influence
and the power of community are key
components. We believe good health
can be contagious, so we’ve created
support groups, a community garden,
and educational programs that are slowly
changing the mindset – and health
prospects – for the 28,000 people who
call Bell County home.
The program has followed a simple
but effective process:
• Participants were recruited
throughout the community.
They were screened for risk
factors such as BMI, cholesterol,
and blood glucose levels.
The results have been impressive:
• Ninety-five percent of participants
who completed the program realized
at least one health improvement
out of five health measures: BMI,
waist circumference, blood pressure,
cholesterol, and/or blood sugar level.
• Participants lost weight, with obese
participants losing 10.2 pounds
on average. Eighty-two percent of
participants reported increasing their
physical activity.
49%
were eating
healthier
by the end of the Team
Up 4 Health program
By the end of the program, 49 percent of
participants reported eating healthier.
I’ve learned a lot. It’s opened
a whole new world. I didn’t
realize how easy it would be
to get into a healthier way of
living and stay with it. It was
like a lifesaver for me.
– Willene Black
Team Up 4 Health Program Participant
82%
of participants in Team
Up 4 Health reported
increased
physical activity
• At-risk individuals were enrolled
in the program and met biweekly
for 10 months.
• Participants learned, shared
and adopted practical health
behavior changes.
• The group engaged in interactive
activities such as learning how to
read nutrition labels, participating in
exercise classes, and attending Q&A
sessions with medical specialists.
10.2
pounds
average weight loss
by participants of
Team Up 4 Health in
the Bell County, KY area
10
Team Up 4 Health follows a
simple notion – people facing
chronic diseases such as
hypertension, obesity, heart
disease or diabetes can make
small behavior changes and
see powerful results that
lead to better health and
lifelong well-being. By
harnessing the power of
community – through existing
social networks and positive
peer-to-peer influence – we’ve
helped people adopt and
spread healthy behaviors.
– Heidi Margulis
Humana’s Corporate Affairs Officer
Mississippi
As the health care exchanges launched
in 2013, there were 36 counties in
Mississippi where no health coverage
was to be offered through the exchanges.
Humana stepped in and filled that gap by
offering exchange-based health plans to
individuals in those communities.
Through that commitment, we began
to engage with state and community
leaders in a new and different way.
Eventually, we engaged deeply with Adams
County and its county seat of Natchez, on
the banks of the Mississippi River. There we
found a community that struggled with
health, but leaders and residents who
really wanted to make change happen.
In November of 2014, Humana and the
Clinton Foundation’s Health Matters
Initiative announced a partnership to help
make Adams County, Mississippi 20 percent
healthier by 2020.
I’m excited about this
partnership because it holds
great promise not only for
Adams County but for the
rest of the state and other
communities, both rural and
urban, we serve across the
nation. We’re confident the
lessons we learn in Adams
County will help us find
health solutions for other
communities as well.
– Erik Eaker
“Humana 2020” Director, Partnerships
The Clinton Health Matters Initiative
(CHMI) uses a model that focuses on social
determinants of health – such as food
and nutrition, infrastructure (e.g. walking
paths), education, financial welfare and
access to care. To address these issues,
the Foundation brings together a diverse
group of stakeholders to discuss challenges
and commit to a set of “bold actions” the
community will take over a five year period.
On December 3, 2014, CHMI hosted the
Adams County Blueprint for Action Day in
Natchez. The event drew 120 community
attendees representing a variety of
backgrounds and organizations gathered to
brainstorm and prioritize health challenges
within the community. As an outcome of
this event, these leaders are identifying the
top 40 bold actions they will implement
to improve the health of Adams County.
The partnership’s Blueprint for Action
will be published this spring as local
and national entities begin their work.
The No. 1 threat to the health
of Adams County is obesityinduced diseases such as
type 2 diabetes and heart
disease. We intend to use our
partnership with Humana and
our community-led collective
impact model to address
this threat by implementing
evidence-based lifestylechange interventions. Such
an undertaking will have
a long-term effect on the
overall health of the people
of Adams County.
– Getty Israel
Clinton Foundation,
Mississippi Regional Director
When I learned that
my company wanted to
invest in Mississippi, the
state where I am raising
my family, I was over
the moon. Mississippians
deserve the highest quality
of care and I am proud to
work for a company that is
truly working to close the
gap between people and
the care they deserve. The
next five years of learning
will be important and will
shape the future of health
in our state.
– Stacey Carter
Humana’s Mississippi Sales Director
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San Antonio, Texas
In 2014, Humana put significant focus on
the city of San Antonio where we have the
potential to impact over 500,000 Humana
members and beneficiaries, over 165,000
visitors to Humana clinics, and 1,300
Humana associates.
Healthy people help drive
a stronger, more effective
health care system. The
challenge is that being
healthy can be hard for all of
us, which is why Humana is
so committed to partnering
with people and communities
to help them get healthy
and stay healthy. Healthier
communities mean a
healthier Humana.
– Pattie Dale Tye
Humana’s Project San Antonio Leader
In July of 2014, Dr. Sandra Delgado, a San
Antonio resident who is the Chief Medical
Officer for Humana’s Government Business,
began efforts to foster collaboration among
San Antonio health leaders and influencers.
She and Humana’s Chief Medical Officer,
Dr. Roy Beveridge, hosted a Clinical Town
Hall that was attended by over 100
Humana and community participants who
engaged in discussions on overcoming
barriers to health and making it easier for
San Antonians to achieve their best health.
The outcome of that session was the
establishment of the San Antonio Health
Advisory Board (SAHAB), a group of local
clinicians and community leaders who
are committed to working together with
Humana to improve the health and
well-being of San Antonio. Partners
include key local organizations such as
Methodist Healthcare, the San Antonio
Food Bank, the mayor’s SA 2020 initiative,
the Bexar County Medical Society and San
Antonio’s Metropolitan Health District.
Our partnership with the city’s largest
grocer, H-E-B is off to a great start.
Collectively, we seek to promote wellness
by addressing nutritional and behavioral
barriers with our H-E-B My Health,
My Way partnership. The My Health My
Way partnership with H-E-B addresses
the barriers that keep consumers
from eating well in San Antonio: cost,
convenience, and culture.
These barriers are being addressed
by programs that change individuals’
relationships with food, such as Healthy
Meals, which promotes healthy cooking and
eating by offering (1) weekly healthy and
inexpensive recipes that include shopping
lists and coupons, and (2) access to
H-E-B’s certified nutritionists to Humana
associates and members.
Because San Antonio has a diabetes rate
that is significantly higher than the national
average, much of our work focuses on
preventing or slowing the progression of
Promoting
wellness
with local partners like
H-E-B, San Antonio’s
largest grocer
As we look to the
future, we are working
on new solutions for
our customers that can
help them overcome
their health barriers
and live more active
and fulfilling lives.
– Chris Kay
Humana’s Chief Innovation Officer
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Potential to impact over
500,000
Humana members
and beneficiaries
to
165,000 visitors
Humana clinics
associates
1,300 Humana
in San Antonio
this condition. We are piloting
in-person solutions to help address
the needs of our members who have,
or are at risk, for low-severity diabetes.
Key pilots include:
The fact that Humana is
partnering with other leaders
in the health industry is a
testament to our level of our
commitment to improve all
the communities we serve.
• Programming in our Las Palmas
Guidance Center where members
can attend Diabetes education
and healthy cooking classes, meet
peers for support and participate
in physical activities like Humana’s
walking program.
• Health Guides who contact
new members by telephone to
help them optimize the use of
their health plan for appointments,
supplies and medications as well as
engage with community resources
focused on diabetes.
• A program with select physicians
to enable them and their patients
to maximize compliance with
recommended diabetes protocols,
such as regular blood level testing,
eye exams and foot exams.
Lastly, we are engaged in efforts to
truly integrate care for San Antonians
through shared data and patient
information that gives all clinicians in
the community a full 360-degree view
of their patients.
– Sandra Delgado, M.D.
Humana Medical Director and
SAHAB Board Chair
Members really appreciate
the guidance we provide
them in managing their
diabetes. There is too much
information for them to
focus on and we, as Health
Guides, are able to provide
the right resources to
improve their health.
– Rosemary Lopez
Humana Health Guide, San Antonio
With key partners, we are developing
a Health Information Exchange
platform that will allow information
sharing between Humana-employed
clinicians as well as other local
providers and hospital systems
across the market. This connectivity
enables the sharing of critical
health information to help improve
the consumer experience and
clinical outcomes for the San
Antonians we serve.
The SAHAB provides a unique
opportunity to bring the
Medical Care and Community
Health Communities of San
Antonio together to improve
the health and quality of life
for San Antonio.
– Peter Wald, M.D.
Vice President and Enterprise Director of
USAA and SAHAB Vice Chair
13
13
Conclusion
Humana is deeply committed to improving
the health of the communities we serve 20
percent by 2020, and we will do this by making
it easy for people to achieve their best health.
Our bold goal not only provides us with the
metric we’ll use to hold ourselves accountable,
it also provides us with the method we’ll use
to close the gap between people and care.
We’ve begun to pursue the goal by providing
integrated care, outstanding clinical
capabilities, and a personalized consumer
experience that start to make it possible for
people to achieve their best health. But we
14
know we can’t do this work alone. Achieving
our bold goal will take long-term
partnerships in the communities we serve.
We seek to co-create and pilot innovative
solutions with partners based on a deep
understanding of communities.
Every day, Humana’s 57,000 dedicated
associates are focused on making our goal
a reality. We are looking forward to combining
the power of their commitment with that of
other like-minded, health-inspired people and
organizations who share our values and want
to make a real difference in American health.
Our values
In pursuit of our bold goal, Humana
will be guided by its core values.
Inspire health
We inspire health by making conscious
choices every day and motivating others
with our positive example. We care
about each other and actively contribute
to an environment of well-being.
Cultivate uniqueness
We find ways to connect with each
other and our consumers. Respecting
one another, listening with an open
mind, and seeking different perspectives
results in richer solutions.
Rethink routine
Innovation emerges from a culture
that cultivates curiosity. We spark
creativity by challenging ourselves
to think differently.
Pioneer simplicity
We make life easier and believe that
less can be more. When we empower
associates with responsibility, we are
able to create an agile organization
and an exceptional experience.
Thrive together
We focus on shared success by breaking
down silos, inviting collaboration and
mentoring others. We believe in, and
act with, positive intention to create
an environment of trust and integrity.
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