William K. Fleming, PharmD

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We’re all on a quest to improve the healthcare experience for our customers via better quality, cost, or access to care. With s

 customers, their numbers, needs, and challenges are growing with each passing year, requiring a more custom approach. A core insight we realized at Humana-and one we challenge the entire industry to adopt-is the need to create a whole-person, value-based health ecosystem that strengthens and improves the senior care experience.

Here’s why it’s so important to adopt this model: 

 of seniors have two or more chronic health conditions, and disease prevalence is expected to increase 44% in the next decade. With such a high rate of illness, it’s alarming to know 

 of seniors find medication adherence challenging. These rates show just how critical it is to find new and better ways to care for seniors with integrated and coordinated tools and resources that better-manage health, while minimizing ER visits and hospitalizations.

There are a few key principles we should follow to better serve our customers:

When working with a large population with chronic conditions, we must help customers navigate a time-consuming, complex healthcare system. This includes partnering with physicians to provide guidance related to their various ailments, as well as helping coordinate doctor appointments, medications, home health visits, and social services, among others.

From our experience, it also means integrating and streamlining the behind-the-scenes customer care processes so that our people, strategies, and organizational infrastructure work in lock-step.

Consumer Satisfaction In Medicare Advantage Plans Rising

Interoperability can be difficult, as member data are often maintained across multiple systems, and clinical strategies and teams haven’t historically worked in tandem. However, with a significant investment by each organization’s leaders to build an 

 clinical operating model, the old model of disparate transactional touchpoints can be replaced, making way for a fully integrated, value-based approach that delivers on the “quality/cost/access to care” promise we all desire.

Five elements seem to have the greatest impact on seniors’ healthcare experience: primary care, pharmacy, behavioral health, home health, and social determinants of health. The latter two are particularly intriguing, because there’s a strong convergence of lifestyle and industry trends.

 Delivering effective home healthcare is becoming a true industry disruption. 

 of seniors want to live at home, but more than half (53%) cite health problems as the top threat to their independence. Technological advancements are helping to bridge the gap, enabling more treatment options in the home-the only setting, comparatively-speaking, that integrates lifestyle and healthcare for effective, lower-cost care. Additionally, programs supporting family caregivers are growing, as we see the inherent benefit of providing robust resources to the ones who are the day-in/day-out constants in their loved ones’ (our customers’) lives-which, in turn, translates to better care.

 Beyond physical conditions, behavioral and social health have a tremendous impact on a person’s well-being. 

 Americans is food-insecure, and a large number of seniors experience social isolation and loneliness. That’s why at Humana, we set forth a 

 to improve the health of the communities we serve by 20% by 2020 and beyond, with much of our work focused on combatting these challenges. If we focus on these once-overlooked areas which can deplete overall healthiness, we have much to gain in improving the health of our customers-and our communities.

In the end, it’s about providing whole-person care that helps people be proactive with their health, backed by the right support to navigate a system that might otherwise be overwhelming.

When we work together to tackle the complexities of modern health and provide solutions that are mutually beneficial, we can all do well by doing good. It’s an approach we’ve wholeheartedly embraced at Humana and challenge the entire industry to follow.

William Fleming, PharmD, is segment president, Healthcare Services at Humana.

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Creating a health ecosystem for our modern-day customer-seniors with evolving healthcare needs and challenges

Author | William K. Fleming, PharmD

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