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The Future of Health
Care In America
Tel Aviv

October 7,2013
Rajni Aneja MD

Strategic Executive, Clinical
Transformation...
Humana background
•

Fortune 100 company

•

Founded in 1961

•

Headquartered in Louisville

•

$39 billion in annual rev...
Health care costs are burdening society
People are
getting older

People are
unhealthier

Structure is
flawed

3
Doing nothing doesn’t work
Medical costs by age and risks

Annual medical costs
$7,000
$6,000
$5,000
$4,000
$3,000
$2,000
...
Consumers are empowered
Demand
easy

Connect
to many

Desire
customization

5
Demand
easy:

Quick, uncomplicated and no hassles

6
Connect
to many:

Enabled by technology

7
Desire
customization:

Tailored to their desires

8
Leading companies evolve from transactions to experience

Why can’t health care?

9
Health care is evolving from sick care to health
Fee For Service

Employer /
Government-Based
Purchasing

Quality / Cost
R...
The building blocks

Genetics

Intake

Prevention

Triage
Navigate

Dx
Rx

Environment

Maintain

Source: Presentation by ...
Personalized quantitative disease progression

12

12
Convergence of mobile, social, devices and analytics
Mobile
Mobile

Social

Personal Devices

Consumer Analytics

13
The future is now

Medicare Advantage is a successful integrated care delivery model

5 million to 15 million
More seniors...
Humana’s Integrated Care Delivery Model

15
Building capabilities
•

Primary care doctors with risk relationship to Humana
– 4,200 affiliated/joint venture
– 3,700 co...
Simplicity that’s sustainable
Win-win partnerships

Providers

Government

Members

Employers

Integrated Care Delivery

E...
Thank You
Humana mHealth / Current Capabilities
MyHumana

•

MyHumana App
–

•

HumanaFit App
–

•

HumanaFit

Workflow optimization...
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mHealth Israel conference, Rajni Aneja, Clinical Transformation Leader, Humana: The Future of Healthcare in America

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Presentation by Dr. Rajni Aneja, Strategic Executive and Clinical Transformation Leader, Humana, Inc, mHealth Israel conference, October 7th, 2013, Tel Aviv. Title is "The Future of Healthcare in America"

Published in: Health & Medicine, Business
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Transcript of "mHealth Israel conference, Rajni Aneja, Clinical Transformation Leader, Humana: The Future of Healthcare in America"

  1. 1. The Future of Health Care In America Tel Aviv October 7,2013 Rajni Aneja MD Strategic Executive, Clinical Transformation leader Humana Inc.
  2. 2. Humana background • Fortune 100 company • Founded in 1961 • Headquartered in Louisville • $39 billion in annual revenues • 49,000 associates • 12 million medical members, 8 million specialty members • Our dream: To help people achieve lifelong well-being 2
  3. 3. Health care costs are burdening society People are getting older People are unhealthier Structure is flawed 3
  4. 4. Doing nothing doesn’t work Medical costs by age and risks Annual medical costs $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 19-34 35-44 45-54 55-64 65-74 75+ High risk Medium risk Non participant Low risk Age range Source: Edington, Zero Trends, 2009 4
  5. 5. Consumers are empowered Demand easy Connect to many Desire customization 5
  6. 6. Demand easy: Quick, uncomplicated and no hassles 6
  7. 7. Connect to many: Enabled by technology 7
  8. 8. Desire customization: Tailored to their desires 8
  9. 9. Leading companies evolve from transactions to experience Why can’t health care? 9
  10. 10. Health care is evolving from sick care to health Fee For Service Employer / Government-Based Purchasing Quality / Cost Reimbursement Models Consumer Choice Industry Evolves from Sick Care to Health 10
  11. 11. The building blocks Genetics Intake Prevention Triage Navigate Dx Rx Environment Maintain Source: Presentation by Dr. David Lawrence at Clinical Care Forum 8/13 Behaviors Rehab Palliate 11
  12. 12. Personalized quantitative disease progression 12 12
  13. 13. Convergence of mobile, social, devices and analytics Mobile Mobile Social Personal Devices Consumer Analytics 13
  14. 14. The future is now Medicare Advantage is a successful integrated care delivery model 5 million to 15 million More seniors are choosing Medicare Advantage Source: April 22, 2010 Letter from the CMS Office of the Actuary (total expected enrollments); Kaiser Family Foundation (MAPD Penetration) 14
  15. 15. Humana’s Integrated Care Delivery Model 15
  16. 16. Building capabilities • Primary care doctors with risk relationship to Humana – 4,200 affiliated/joint venture – 3,700 contracted – 270 employer-based worksite and occupational medicine sites • Extended care capabilities (Humana Cares, American Eldercare) – 9,000 dedicated doctors and nurses – 212,000 members in chronic care program • Fourth-largest Pharmacy Benefits Manager – 240 million prescriptions processed – 20 million prescriptions dispensed • Motivating/measuring wellness – 2.7 million HumanaVitality members 16
  17. 17. Simplicity that’s sustainable Win-win partnerships Providers Government Members Employers Integrated Care Delivery Engaged in their health Quality and Cost Improvement Productivity 17
  18. 18. Thank You
  19. 19. Humana mHealth / Current Capabilities MyHumana • MyHumana App – • HumanaFit App – • HumanaFit Workflow optimization and enhanced communication efficiency across caregivers, clients and their family support network SMS – • Fitness and activity tracking Caregiver App (“Betty”) – • Member health and well-being management Medication Adherence & Prescription Re-fill Reminders, Account Balances, Health & Wellness Tips Betty Caregiver App Telehealth – Pilot project aimed at better care for members with congestive heart failure • Bluetooth-enabled scales and blood pressure monitors, linked to a cellular modem and Interactive Voice Response Technology 19
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