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

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"

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mHealth Israel conference, Rajni Aneja, Clinical Transformation Leader, Humana: The Future of Healthcare in America Presentation Transcript

  • 1. The Future of Health Care In America Tel Aviv October 7,2013 Rajni Aneja MD Strategic Executive, Clinical Transformation leader Humana Inc.
  • 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. Health care costs are burdening society People are getting older People are unhealthier Structure is flawed 3
  • 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. Consumers are empowered Demand easy Connect to many Desire customization 5
  • 6. Demand easy: Quick, uncomplicated and no hassles 6
  • 7. Connect to many: Enabled by technology 7
  • 8. Desire customization: Tailored to their desires 8
  • 9. Leading companies evolve from transactions to experience Why can’t health care? 9
  • 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. 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. Personalized quantitative disease progression 12 12
  • 13. Convergence of mobile, social, devices and analytics Mobile Mobile Social Personal Devices Consumer Analytics 13
  • 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. Humana’s Integrated Care Delivery Model 15
  • 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. 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. Thank You
  • 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