Business First – By Chris Larson Reporter, Louisville Business First
Humana Inc.’s population health project, Bold Goal, appears to have helped its local insurance members improve their health — even during the coronavirus pandemic.
New data for 2020 released by Humana’s Bold Goal team shows that Louisville-area Medicare Advantage members, seniors on government-backed health plans administered by Humana, saw unhealthy days decrease by 1.8% compared to 2019, just behind the national measure.
Representatives of the company note Louisville had started off in 2015 with members self-reporting the lowest number of unhealthy days in the original seven Bold Goal markets. That said, it had seen a prevailing trend of increasing numbers of unhealthy days since 2016.
“Louisville has actually been an outlier in a bad way over the first three or four years,” Dr. Andrew Renda, vice president of Bold Goal and population health for Humana, said in an interview. “I think it’s a testament to a lot of the work that’s happening… There were a lot of good things happening in Louisville.”
At a national level, Humana Medicare Advantage members in the 16 Bold Goal communities saw the following results in 2020 compared to 2019:
- Physically unhealthy days — decrease by 5.1%
- Mentally unhealthy days — increase by 2.2%
- Total unhealthy days — decrease by 2.2%
Compare that to Humana Medicare Advantage Members in non-bold goal markets
- Physically unhealthy days — decrease by 2.4%
- Mentally unhealthy days — increase by 5.4%
- Total unhealthy days — increase by 0.6%
Pandemic magnified existing social problems impacting health care
The coronavirus appeared to magnify mentally unhealthy days across the board as any number of safety measures by the government and businesses in 2020 injected additional isolation into many Americans’ lives.
But social isolation and loneliness already presented a vexing problem for American seniors.
“Loneliness and social isolation were probably the most profound social determinant that came of the pandemic for a variety of reasons,” Renda said,
Renda said as many as 1-in-5 American seniors were grappling with social isolation and loneliness pre-pandemic. And after the pandemic hit, that ratio jumped to as many as 1-in-3 seniors.
The Bold Goal’s efforts to improve the Healthy Days include Humana partnering with local organizations. Specifically, organizations that partner with Humana do so to address members’ social determinants of health. The Bold Goal effort focuses on addressing food insecurity, access to transportation, social isolation and loneliness, housing security and financial strain.
Apart from the Bold Goal, Renda said Humana’s approach to supporting members across its enterprise evolved following the onset of the pandemic. At first, Humana focused on programmatic changes such as supporting switching certain medical appointments to telehealth, allowing 90-day prescription refills and having members switch to Humana’s in-house mail-order pharmacy.
But as many as 2,000 people a day, back in March and April 2020, told the company that they were food insecure. Humana’s Basic Needs Program delivered about 1.5 million meals to 85,000 of its members.
“On the one hand, I’m incredibly proud that we did that, and we were able to address that need,” Renda said. “On the other hand, it’s almost inconceivable that many of our members had that type of need. … That’s what happened in the pandemic — things that you might have been there before suddenly [had] a light shone on them.”
How Humana’s Bold Goal changed and how the Bold Goal could change Humana
The evolution of Humana’s approach to helping its members is reflected in the last five years of the Bold Goal effort. The efforts behind the Bold Goal could also flow into larger Humana operations.
Much of the focus in the early efforts were on addressing chronic conditions such as heart disease and diabetes, Renda said. But the company found it could make a bigger impact through social determinants of health rather than focusing on addressing chronic conditions.
“We’re to the point where we’re trying to achieve, what our CEO [Bruce Broussard] would call operational maturity when it comes to the social determinants work,” Renda said, adding that the work on social determinants of health provides proof points to justify larger investments in those efforts.
Given Humana’s scale and focus on Medicare Advantage — one estimate shows that Humana enrollees make up 18% of national enrollment that totals about 24.1 million in 2020 — the company could address social determinants of health of its members in several ways, Renda said. These include changing provider reimbursement arrangements to captivated monthly payments to care for members; changing plan benefit designs or supplemental benefits; adding social determinants to its care coordination platform.