Patient Engagement

Humana’s Bold Goal population health program seeks to topple barriers to healthy living

Humana's population health initiative aims to slow the progression of chronic diseases by focusing on prevention and addresses food insecurity, transportation resources, and health literacy through community partnerships.

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Your grandfather’s health insurance company may have just processed claims, but not today’s insurers.

Take the example of Humana. the Louisville, Kentucky insurer. Two years ago, Humana launched a population health initiative with a focus on prevention and slowing the progression of chronic diseases. Food insecurity, transportation resources, and health literacy are a few of the priorities the Bold Goals program seeks to address through community partnerships.

Typically population health efforts zero in on prevention and stabilization of disease, but from Andrew Renda’s perspective as the director of Humana’s Bold Goal Measurement, this approach has some significant drawbacks.

“We can’t help individuals achieve their best health without understanding health habits and barriers within families, the built environment and the community at large.” he said. “Our Bold Goal is to improve the health of the communities we serve because we want to make health easy, which means starting at the local level,”

Renda will deliver a keynote address at MedCity’s patient engagement conference, ENGAGE, on Oct. 18 in San Diego and talk at length about this population health program.

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Andrew Renda, director, Office of the CMO, Humana

The insurer centers its clinical initiatives on six priority conditions — congestive heart failure, coronary artery disease, hypertension, COPD, diabetes and depression.

“We chose these based on incidence, prevalence and health impact,” Renda said. “Over time, we may add others – for instance, cancer, musculoskeletal conditions and additional behavioral health conditions, such as anxiety and substance use disorder.”

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MedCity ENGAGE is an executive-level event that features the most innovative thinking from hospital systems, providers, insurers, health IT, doctors and other innovators to discuss best-in-class approaches to advance patient engagement and healthcare delivery. The 4th annual MedCity ENGAGE will be held October 18-19 in San Diego Register now.

The first stage of Bold Goal involves choosing the most appropriate communities to add to the program. The selection process is influenced by a combination of membership, Humana employees, community engagement and health challenges the insurer believes the program can improve.

A “Clinical Town Hall,” as Renda describes it, is held to highlight opportunities and priorities and to get the community engaged and ready to work together. San Antonio was the first community for Bold Goal, followed by Tampa Bay and Louisville in 2015. This year, Humana expanded the program to Baton Rouge, Broward County in Florida, Knoxville and New Orleans.

In each location, the Bold Goal team examines patient data and collaborates with local stakeholders to identify two to three chronic conditions and two to three barriers to health.

So how does Humana coordinate the different moving parts? ”

A corporate team housed under the Office of the Chief Medical Officer, based out of the insurer’s corporate headquarters in Louisville, leads the high level strategy. Each community has local integration leaders, Humana employees and market leadership who help keep the communities engaged through Health Advisory Boards, said Renda.

A 2016 progress report on the initiative highlighted how the insurer works to confront the specific needs of each community and the progress the Bold Goal program has made.

In San Antonio, the first community to take part in Bold Goal, diabetes is one of the chronic conditions Humana has targeted. The insurer developed pilots with Omada Health, which developed a digital health diabetes prevention program, and diabetes management business Livongo, the report read.

To reduce the reliance on 911 for nonemergencies in San Antonio,
Humana worked with emergency medical services and harness Availity, a health information network. Paramedics use Availity to find patient lab and test results, determine when they last received their medication or saw the doctor and make an appointment if needed.

In Tampa Bay, where the program identified behavioral health as a priority, the Bold Goal initiative doubled depression screenings over 2015.

A cooking class for a Thanksgiving meal was designed to help residents of the city of Natchez in Mississippi, a state with the second highest adult obesity rate in the country. The class seeks to improve participants’ understanding of the relationship between healthy eating and healthy living by showing them healthier ways to prepare food.

Longterm, Bold Goal seeks to improve the health of its members by 20 percent. Members use the Center for Disease Control’s Healthy Days app to track health improvement by gauging how they feel about both their physical and mental health, Renda noted. The company also uses underlying claims-based data on health conditions that can be correlated with Healthy Days.

“We take random samples of our national membership and in individual Bold Goal communities to establish baselines and then show trend towards the 20 percent goal…As we launch new initiatives through our Health Advisory Boards, we will survey community members as well,” Renda said.

Photo: Humana and Freedigitalphotos.net user suphakit73

 

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