Humana has introduced the Humana Care Support pilot program, marking a significant step forward in chronic disease management for seniors. This innovative program is designed to provide enhanced care for Medicare Advantage members, leveraging integrated care management and advanced data analytics. This initiative underscores Humana’s commitment to improving the health and well-being of seniors, particularly those managing chronic conditions.
Humana Care Support represents the evolution of Humana’s care management services, building upon previous successful models. As highlighted in a press release, this next-generation program focuses on delivering customized, integrated, and coordinated care. The core objective is to empower seniors to manage their health more effectively while remaining comfortably at home. This approach addresses not just physical health but also the crucial social and behavioral aspects of aging in place. Previously known as the Enterprise Clinical Operating Model (ECOM), Humana Care Support reflects a refined and enhanced strategy in senior care.
The pilot program is specifically targeted at seniors grappling with complex health challenges, including congestive heart failure, diabetes, and multiple chronic conditions. A cornerstone of Humana Care Support is its integrated care management model. This model ensures that each senior benefits from a multi-disciplinary team of healthcare professionals. This team includes experienced nursing staff, dedicated pharmacy support, social workers to address social determinants of health, and behavioral healthcare specialists to support mental well-being. This comprehensive approach acknowledges the interconnectedness of various health factors in managing chronic diseases effectively.
The design of the Humana Care Support member experience is deeply rooted in collaboration. Humana actively sought input from key stakeholders, including the seniors themselves, their caregivers, physicians, and other healthcare professionals. This collaborative approach, which involved direct engagement and simulations of member and caregiver interactions, ensures that the program is truly patient-centered and responsive to the real-world needs of its users. By prioritizing the member’s voice, Humana aims to create a care experience that is both effective and empathetic.
Humana Care Support strategically utilizes value-based care agreements and proven care management strategies. These established frameworks are essential for delivering integrated care within the Medicare Advantage framework. The program’s focus extends beyond traditional clinical care to encompass the social determinants of health. Recognizing that factors like access to food, housing, and transportation significantly impact health outcomes, Humana’s program is designed to address these broader needs, leading to more holistic and effective chronic disease management.
Data analytics plays a pivotal role in the Humana Care Support program, enabling personalized care delivery. By leveraging advanced cloud technology, seamless data integration, and sophisticated visualization tools, healthcare providers gain access to real-time member data. This capability for real-time data analytics is increasingly crucial in today’s healthcare landscape, allowing for timely and informed decision-making. Especially in dynamic situations, such as public health crises, the agility provided by real-time data is invaluable.
Heather Cox, chief digital health and analytics officer at Humana, emphasized the program’s analytical capabilities. “Humana Care Support will empower physicians, clinicians, and care teams to use both predictive and reactive analytics to proactively identify individuals who require support,” Cox stated. This proactive approach allows for timely intervention and personalized care strategies. Furthermore, understanding individual member priorities enables Humana to tailor comprehensive care plans that address medical, behavioral, social, and financial needs. For example, analytics can identify medication non-adherence, prompting outreach from social workers to explore social determinants of health or pharmacists to discuss medication management strategies.
A primary goal of Humana Care Support is to facilitate senior care within the home environment, minimizing the need for transfers to institutional facilities. This aligns with a growing trend among payers, including Aetna, who recognize the benefits of home healthcare for managing chronic diseases in Medicare Advantage members. The preference for aging in place is strong among seniors, and Humana’s program is designed to honor this preference while ensuring high-quality care.
William Fleming, pharmD, segment president of clinical and pharmacy solutions at Humana, highlighted this patient-centered approach. “Long before the pandemic, the home has become the preferred setting for older adults with multiple chronic diseases to receive care and age in place,” Fleming noted. Humana Care Support leverages best practices in coordinated home health, in-home care management visits, and virtual consultations. These modalities work in concert to help members achieve better health outcomes from the comfort and familiarity of their own homes.
Initially launched as a pilot in Kentucky, Pennsylvania, and West Virginia, Humana Care Support is set to expand to additional states throughout 2021 and beyond. While home-based care is a priority, Humana acknowledges that long-term care facilities remain necessary for some seniors with highly complex conditions. In line with this understanding, Humana is also actively working to enhance the member experience in long-term care settings. For instance, their value-based hospice care coordination model aims to improve end-of-life care for Medicare Advantage members, ensuring they can access hospice services promptly and make informed decisions about their care journey.
Furthermore, Humana is embracing artificial intelligence to enhance member engagement across all its programs. A partnership leveraging AI-powered virtual assistants is designed to streamline member interactions, providing quick answers to common queries and improving overall service efficiency. This reflects Humana’s broader strategy of using technology to improve both care delivery and member experience.
In conclusion, the Humana Care Management Program, embodied in Humana Care Support, represents a significant advancement in senior chronic disease management. By integrating personalized care, data-driven insights, and a focus on home-based services, Humana is addressing the evolving needs of seniors and setting new standards for comprehensive, patient-centered healthcare in the Medicare Advantage landscape. This program is poised to make a meaningful difference in the lives of seniors, empowering them to live healthier, more independent lives at home.
