Humana Rolls Out Chronic Care Management Pilot Program To Select States

Humana Inc. recently announced the launch of its Humana Care Support pilot program, with the goal of improving the overall health and wellbeing of select Medicare Advantage members by addressing social and environmental determinants of health in conjunction with ongoing medical treatment. Members will be served by a team of multiple clinicians, including a nurse, pharmacist, social worker, and a behavioral-health specialist.

The program, which evolved from Humana’s Enterprise Clinical Operating Model, is initially being rolled out to a trial group of members in West Virginia, Pennsylvania, and Kentucky, all of whom are living with multiple chronic medical conditions such as complex congestive heart failure and diabetes. By leveraging improved analytics, the clinical care teams can assist Medicare Advantage members by providing personalized and integrated care that looks beyond their recorded health histories and into where and how they live, work, play, and age. By taking these additional factors into consideration, member health outcomes can be improved by directly addressing specific individual barriers to health like food insecurity, healthcare literacy, transportation challenges, and others. The company plans to expand the program to Medicare Advantage members in more states later in 2021.

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According to Heather Cox, Chief Digital Health and Analytics Officer at Humana, “Humana Care Support will help physicians, clinicians and care teams use predictive and reactive analytics to identify who needs help...When you have an understanding of what’s most important to the member, you can leverage personalization to deliver comprehensive care that not only addresses medical needs, but also behavioral, social and financial ones.”

The move marks the latest advance in an industry effort to address social and environmental determinants of health, recognizing the impact that they can have on both short and long-term health outcomes. While access to high quality healthcare contributes to improved health, it has a small impact on factors related to premature death, with the overwhelming majority of factors falling outside the healthcare system entirely.

With more than half of those factors being influenced directly by social determinants it becomes increasingly important to address a whole-person view of health. By putting the focus on the ‘big picture’ when it comes to patients with chronic conditions, the company aims to use this new technology to ultimately help its patients lead healthier and more complete lives.