Humana Bold Goal Targets Members’ Social Determinants of Health

March 27, 2018 - Humana is improving the overall physical and mental health of its Medicare members by addressing social determinants of health and targeting problematic community health behaviors under its Bold Goal initiative.

The Bold Goal 2018 Progress Report reveals that implementing community-level changes has led to positive health outcomes for elderly beneficiaries with diabetes, heart disease, respiratory conditions, mental health issues, and other chronic diseases.

Humana looked for patterns of key social determinants within senior citizen populations such as food insecurity, housing instability, limited English proficiency, social isolation, and inadequate emotional support. The payer found these social determinants had a strong correlation with poor beneficiary health.

Older beneficiaries that had limited access to healthy food options were 50 percent more likely to develop diabetes, 14 percent more likely to experience higher blood pressure, and had a 60 percent higher chance of having a heart attack.

Social isolation was cited as a significant social determinant of health for elderly beneficiaries. Humana Medicare members living in social isolation had a 26 percent higher likelihood of dying prematurely than members who lived with friends or family. These socially isolated members also had double the risk of Alzheimer’s disease.

“As the nation’s senior population grows, they’ll play a larger and more vital role in all of our communities,” said Bruce D. Broussard, Humana’s President and CEO.

“Seniors face unique challenges, including living with multiple chronic conditions and social determinants that can lead to poor health. Learning to solve these issues will help all of us. By slowing chronic disease progression through a holistic approach to personalized care, we can help physicians and other care professionals provide care that helps seniors prosper -- physically and mentally.”

Humana’s Bold Goal project uses a population health metric developed by the CDC called “Healthy Days” to track overall health status. A “healthy day” indicates a beneficiary that had positive physical and mental health measures such as blood pressure, blood-glucose level, emotional health, and social support.

Humana members in the San Antonio Bold Goal Community experienced a 3.5 percent improvement in the number of reported Healthy Days after the payer established pilot programs to address common social determinants of health.

Humana found that food insecurity, poor nutrition, and poor health literacy for elderly beneficiaries exacerbated the prevalence of diabetes and behavioral health issues in San Antonio.

The payer worked with stakeholders, including community health groups affiliated with the American Diabetes Association, to develop multiple programs that address food insecurity and health literacy.

The programs included a free diabetes resource guide to educate members on personal wellness, a publicly available resource directory, a partnership between San Antonio food bank and MCCI Medical group, and YMCA educational programs.

The Bold Goal community in Louisville, Kentucky experienced similar outcomes after Humana helped to address transportation barriers for individuals with respiratory conditions.

Humana established programs like a COPD pilot initiative that uses a self-triage mobile platform to assess the functional status of elderly Humana members living with COPD.

These and other community initiatives led to a one percent improvement in the number of Healthy Days reported by members with COPD. The payer also attributed increases in Healthy Days to a partnership with the Louisville Metro Housing Authority to make housing smoke-free.

Additionally, the Louisville Bold Goal community experienced improvements in mental health and antidepressant adherence after developing emotional wellness programs like suicide prevention outreach. Fifty-nine percent of Humana Medicare beneficiaries with depression maintained antidepressant adherence, which is four percent higher than the national average.

Leaders at Humana emphasized that the key to addressing social determinants of health is scaling payer-community partnerships to create a holistic healthcare experience for vulnerable beneficiaries. The payer hopes to improve beneficiaries’ overall health by 20 percent by the year 2020 and believes it has taken the right steps towards that goal.

“As the US population ages, we need to support their needs as well as the nurses, physicians and caregivers who are providing direct services and care,” Broussard concluded. “Our Bold Goal has helped us understand the needs of our members and communities better.”

“There is still so much more to do to reach 20 percent better health by 2020, but our focus on collective impact and addressing social determinants of health inside and outside of the clinical setting is leading us toward more Healthy Days.”