Addressing the social determinants of health—access to healthy food, social isolation, safe housing, and financial stability—can help lower costs and improve outcomes.
Humana is targeting these social determinants in communities through its Bold Goal strategy.
“Health is local and most of what makes us healthy happens outside of the clinical setting,” says Roy Beveridge, MD, chief medical officer for Humana, and a member of the Managed Healthcare Executive Editorial Advisory Board. “By working with nonprofit organizations, business, government and faith-based community partners, as well as physician practices, we are taking a collaborative approach to care. No one person or organization can do this work alone.”
The aim of the Bold Gold strategy is to improve the health of the communities it serves 20% by 2020. The population health strategy focuses on improving physical and mental health conditions by addressing social determinants of health such as food insecurity, social isolation, and loneliness in its employees, members, and communities. Progress is being tracked through the CDC’s health-related quality of life measurement (HRQoL) tool, Healthy Days, which measures an individual’s mental and physical Unhealthy Days over a 30-day period.
Every Unhealthy Day a patient adds $15.64 per person per month in additional healthcare costs, according to Beveridge referencing a recent study in the American Journal of Managed Care.
“While disease is a natural part of aging, in our business we know that many of our members suffer from more than one chronic condition,” he says. “We also know that many are food insecure, lonely, or socially isolated, which exacerbates those conditions. By taking a more collaborative, integrated, and personalized approach to care we can improve medical costs and the health outcomes of our members.”
Through partnerships and test-and-learn interventions Humana is demonstrating how addressing a barrier to health—such as access to healthy food—can impact a person’s overall health outcomes and well-being.
Here are two examples of where Humana’s efforts are paying off:
San Antonio. The city experienced a 3.5% improvement in Healthy Days in their Humana Medicare population in 2017. In addition, San Antonio Healthy Days improved 5.1% in Humana seniors living with diabetes. “These improvements, as well as those in diabetes-related clinical outcomes, were impacted by the collaborative work of the San Antonio Health Advisory Board and the Humana San Antonio Bold Goal team to address diabetes and food insecurity throughout San Antonio,” Beveridge says.
The San Antonio Health Advisory Board (health-minded organizations, including not for profits, city and county government and businesses) collaborated with the American Diabetes Association to create a Diabetes Resource Guide website.
San Antonio also created the Path to Wellness, a partnership with H-E-B grocery store and the YMCA to address nutrition and health literacy for people living with diabetes. In addition, to address food insecurity, the city created a partnership between MCCI medical clinics and the San Antonio Food Bank so that patients could have access to monthly onsite food distributions.
2. Tampa Bay. Humana Medicare members living in Tampa Bay experienced a 3.2% decline in Healthy Days due to hurricane-related impact, but among Humana members living with depression, there was a slight improvement. “We feel this is due to the efforts of the Tampa Bay Bold Goal Health Collaborative—formerly the Tampa Bay Health Advisory Board—and the Humana Tampa Bay Bold Goal team, that is focused on addressing loneliness, social isolation, food insecurity, and behavioral health in Tampa Bay,” Beveridge says.
Humana was a founding member of the Hunger Action Alliance (along with University of South Florida and Feeding America). The alliance will both study social determinants of health as well as deploy interventions against them. “The first study undertaken is called Factors Affecting Older Adults, and looks at the prevalence and associations between food insecurity, loneliness, and depression,” says Beveridge.
In 2017, the Tampa Bay Bold Goal Health Collaborative and Humana Tampa Bay Bold Goal team hosted more than 50 faith-based leaders in a forum to discuss depression and bipolar disorder in the community. During the forum, teams discussed solutions for the current lack of services available and plan to continue that work into 2018, according to Beveridge.
Currently the plan is to expand the event and host it in each of the three different counties which make up Tampa Bay—Pinellas, Pasco, and Hillsborough—in September with a goal of working with local faith-based leaders to bridge the gap between what they know and the behavior health services in the community to address the concurrent issues of anxiety, depression and the opioid crisis. A recommendation came out of the 2017 Faith Based Forum to provide Mental Health First Aid training to a greater number of folks in the community, and a focus of the events being held in September will be on evaluating that suggestion and determining if it is the right solution for the community, according to Beveridge.
“Good health is good for business,” Beveridge says. “Our Bold Goal is not just building sustainable relationships and connecting people to the resources they need, it’s about improving clinical outcomes, which has an ROI.