Recommended
Recommended
More Related Content
What's hot
What's hot (19)
Similar to HIMSS + Humana
Similar to HIMSS + Humana (20)
Recently uploaded
Recently uploaded (20)
HIMSS + Humana
- 1. 0 83.7 million by 2050 people enrolling in Medicare each day 10,000 Americans aged 65 and older has one or more chronic condition in3 4
- 2. 1
- 3. $3 Trillion per person 2 60% by treating unmanaged behavioral health 34% by preventing chronic diseases 14% by reducing unnecessary services 30% by providing better at home health >$600k a year of treatment for some specialty drugs
- 5. High Tech + High Touch incorporates social factors identifies challenges and opportunities incorporates the right technology 4 Building a comprehensive health care strategy
- 6. diabetes 4x Higher health care costs for diabetes and depression versus a person with just diabetesdepression 6x Greater health care costs cancerdepression 4x More likely to be rehospitalized within a year of discharge for isolated seniorsseniorsisolation 5
- 7. Members Physicians Communities Rethinking the way we do business 6 Using Cutting Edge Technology | Sharing Data | Building Relationships
- 8. <1 hour of face time a year 7 8,760 hrs in a year 8,759 hrs left
- 9. Congestive Heart Failure Weight Monitoring Program (CHF) Predictive Modeling to Prevent Falls Using Digital Technology to Connect with Patients 8 Virtual Diabetes Prevention Program Omada Health
- 10. Measuring progress with Healthy Days Total unhealthy days physically unhealthy days mentally unhealthy days 9 In the last 30 days, how many days have you physically not been well? 1 In the last 30 days, how many days have you mentally not been well? 2
- 11. 52 inpatient admissions per 1,000 patients .28 day increase in average length of stay $93 increase in annual member out-of-pocket expense $82 increase in per member per month medical and prescription cost for every 5-day increase in unhealthy days 10 The Case for Healthy Days
- 12. The Case for Healthy Days 1 unhealthy day a month is associated with a $15.64 Per Member Per Month in monthly medical costs +3 million Medicare members +300 million? 11
- 13. 12
Editor's Notes
- People like George are suffering. George has a lot of barriers to good health. He’s on a fixed income, has diabetes and depression. He lives alone, isolated from his family and he’s food insecure. He’s a high risk patient. George is our future. Click - By 2050, the population that is 65 and older is going to double to over 83 Million Click - 10,000 new people are enrolling in Medicare each day… Click - And three in four Americans aged 65 and older has one or more chronic condition This is happening in a system that’s already unsustainable.
- Today, we have the ability to gather more data about human health than ever before. Yet, we still struggle to improve population health. Our system is expensive and deeply fragmented.
- We spend almost 3 trillion dollars on health care in the U.S. ($10,000/person) but we could to reduce that… One Click for all - By up to 34% by preventing chronic diseases. By 14% by eliminating unnecessary services such as repeated tests. By 30% by providing better at-home health. And by 60% by treating unmanaged behavioral health. We also know that specialty drugs are expensive. Sometimes cost over $600K a year for treatment. We can reduce that too.
- I know that there are people in this room working to create better technology to integrate data to help eliminate some of this fragmentation, but ultimately, to improve health, it is going to require more than just connecting data and systems. Click - We have to connect to people, physicians and communities as well – building relationships and working together to improve health.
- By combining high tech with high touch - we can better help people like George. It requires building a comprehensive population health care strategy that - Incorporates social factors- Identifies challenges and opportunities- And incorporates the right technology to facilitate better care and quicker access. We can no longer treat mental health and physical health separately, or forget about what is happening outside of the clinical setting, because health is holistic.
- This is what we have learned at Humana - Click – People who have diabetes AND depression have 4 times higher health care costs than a person with diabetes alone. Click – A person with cancer and depression has 6 times greater health care costs. Click – And a senior who is lonely or socially isolated, a key social determinant of health, is 4 times more likely to be rehospitalized within a year of discharge
- These factors contributed to us rethinking the way we do business - Click – We’ve changed the way we work with our Humana members, physicians and with our communities - Click – by using cutting edge digital technology, sharing data and building relationships.
- On average a patient visits their doctor maybe 2 to 3 times in a year, which equates to less than an hour of face to face time. Click – What happens with the other 8,759 hours that patient isn’t seeking care?
- We developed pilots by using digital technology to better support members where they are – and we share that data with physicians. For instance - Humana piloted a Congestive Heart Failure (CHF) Weight Monitoring Program that provides patients with a cellular weight scale that transmits their weight to their physician’s office. The goal is to prevent hospital admissions as weight gain for this population is a leading indicator of a potential hospital admission. Through predictive modeling we are developing better ways to identify risks in older adults, like the risk of falling. And we are giving that data to physicians so that they can better care for their patient who might be at risk. And we are testing digital capabilities with our older adult population through a virtual diabetes prevention program with Omada Health.
- We’re measuring progress through the CDC survey tool, Healthy Days, which measures both mental and physical health of an individual over a 30 day period. We ask members two questions: in the last 30 days, how many days have you physically not been well and In the last 30 days, how many days have you mentally not been well? Again, taking into account the whole person.
- Healthy Days is a population health measurement that provides a cost savings opportunity. In fact, a literature review conducted by Humana, the Robert Wood Johnson Foundation, CDC, and Columbia University – validated that Healthy Days is a simple yet effective survey tool to measure a person’s perception of their own health. Using claims data, we found that the number of unhealthy days a person has directly correlates with more hospital stays, higher healthcare utilization and higher costs of care. For instance… Click - For every 5-day increase in unhealthy days in fact, there is: An increase of 52 inpatient admissions per 1000 patients- 0.28 day increase in average length of stay - $93 increase in annual member out-of-pocket expense - $82 increase in per member per month medical and prescription cost.
- An increase of one unhealthy day a month is associated with a $15.64 Per Member Per Month savings in monthly medical expenses – Click - imagine if we could help improve just one unhealthy day of each of our 3 million plus Medicare members? Click - Or how about the entire U.S. population (300+ million)?
- Using a high tech, high touch approach is multifaceted, but at the end of the day it’s about data and connecting systems as much as it is about building relationships, sharing, and learning with people, physicians and communities. Working together is the only way we are going to help improve population health, reduce medical costs and make sure people like George are getting the care they need.