Payer social determinants of health strategies are moving into a new phase, as Humana’s latest Bold Goal report demonstrated.
Over the past few years, payers have gained deeper knowledge about the social determinants and conditions that bar different demographics from healthy lifestyles. In response, they have developed solutions for the problems that manifest from these barriers.
For Humana, that came in the shape of The Bold Goal program.
Launched in 2015, Humana’s chief executive officer Bruce Broussard put forward the program’s aim: to improve members’ health by 20 percent in five years.
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“Our CEO put this goal out there of improving the health of the people we serve by 20 percent and he sort of looked at our team and said, ‘figure out what that means, figure out how you measure it, and so forth,’” Andrew Renda, associate vice president of population health at Humana, told HealthPayerIntelligence. “And that’s what led us down the path of using the Centers for Disease Control and Prevention (CDC) Healthy Days tool.”
The team set out to increase members’ Healthy Days as defined by the CDC. The CDC metric observes members’ mental and physical health characteristics over the course of thirty days. Humana analyzed these characteristics in a set of 14 Bold Goal communities, which included cities such as Louisville, Kentucky where Humana is headquartered.
Since launching, Bold Goal communities have seen increases in healthy days and Humana has expanded the program beyond its original 14 communities.
This past year, Humana tracked Healthy Days for five chronic conditions—chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), depression, congestive heart failure (CHF), and hypertension. Each of these categories saw a decline in “Unhealthy Days” in 2019, ranging from 1.2 percent fewer Unhealthy Days for members with COPD to 3.2 percent fewer Unhealthy Days for members with hypertension.
Renda attributed this largely to Humana’s approach of tackling chronic conditions and social needs simultaneously. An intentional population health management strategy is key to helping members successfully pursue their chronic disease management.
For example, patients with diabetes are known to see a spike in emergency department visits and hospitalizations in the third and fourth weeks of the month. While the true cause remains unproven, many speculate that it is related to food insecurity. With that in mind, Renda said, Humana developed an intervention that delivers meals to members with diabetes in the third and fourth week of every month.
With social determinants of health being so core to their overall company philosophy, one of Humana’s aims for 2019 was to increase its social determinants of health screening rate. The Bold Goal’s new goal was to increase screenings by 1 million in 2019.
Humana not only achieved 1 million screenings last year but exceeded the target by conducting a total of 2.6 million screenings, nearly tripling its original goal.
This was a result of momentum coming from internally and also from Humana’s partners, Renda said. The payer offered the screenings in various formats through multiple channels. Consumers might be screened via a traditional direct-to-consumer approach, through an intervention, or through provider partners, to name a couple of options.
Around 100,000 of those responses came from the Medicare population alone, Renda highlighted. For this group, Humana used a comprehensive screening instrument that captured data from 10 to 12 different social determinants of health domains. Because of the study’s unusually large sample size, the insights from this study, set to be published later this year, helped confirm with greater confidence some of the widespread social determinants barriers facing seniors, including financial instability, food insecurity, and transportation.
The millions of screening responses contributed a strong, new data set for Humana’s advanced analytics tools, which is pivotal for the company’s strategy surrounding social determinants of health and chronic disease management going forward.
Source: HealthPayer Intelligence