Humana Cares, a national division of Humana, provides support and customized coaching for more than 160,000 older adults with chronic illnesses, their families, and caregivers across the country.
Humana, like most health insurance companies, searched for the best way to reduce hospital readmission rates and the associated costs for congestive heart failure (CHF) patients. Humana needed to increase member self-management of CHF in order to improve health, reduce catastrophic events, and lower costs
Humana Cares developed an extensive support program for CHF patients in 33 states, which included daily biometric monitoring and education with the Intel-GE Care Innovations Guide platform. The program was designed to affect behavior change and create lifelong habits among CHF patients who have had recent hospitalizations or ER visits.
In less than a year, preliminary results indicate the Care Innovations Guide platform is an effective and valuable element of the Humana Cares CHF care management program:
- 80% adherence rate by members who opted to have daily biometric monitoring
- 94% of members said the Guide was easy to use, 90% said they felt more connected to their nurse, and 93% would recommend it to their friends
- Positive anecdotal feedback from members that the Guide has helped them develop positive lifelong habits and better manage their chronic conditions
- Enabled Humana to reach CHF patients in remote areas that may have otherwise gone unmonitored for long periods of time
Humana Cares plans to evaluate the success of the program by measuring ROI, admission and readmission rates for members with CHF, as well as ER visits for members with CHF.
Lowering Health Care Costs through Technology-Enabled Disease Management and Behavior Change
Humana recognized the potential to dramatically improve the health status of members with congestive heart failure (CHF). Based on lessons learned from other programs, Humana focused on facilitating long-term behavior change through more personalized care. If the company could achieve this, Humana knew their members would experience fewer readmissions and lower complication rates, ultimately improving quality of life and reducing overall health care costs.
Humana Cares developed an extensive support program for 2,000 CHF patients. In addition to benefiting from a comprehensive disease management program and social services support that addressed an array of challenges, CHF patients participated in daily biometric monitoring and education with the Guide. Daily weight and blood pressure measurements were automatically sent to a Humana Cares nurse who could easily assess the health status of all patients through the Intel-GE Care Innovations Guide - Virtual Care Suite and identify any abnormalities, such as a patient gaining three pounds in one day. The nurse could then contact the patient, set up a videoconference using the Guide, and discuss why the change may have occurred. Did the patient run out of medication, or fail to recognize the sodium content was high in his last meal? Moments like these encourage what Humana Cares calls “just in time” learning opportunities, which are extremely effective in producing long-term behavioral change. Because Humana Cares nurses intervene at the first sign of trouble, patients gain a personal understanding of which habits exacerbate CHF symptoms and how they can overcome these obstacles.
The Guide is customized to meet the individual needs of the patients and their treatment plans. Humana Cares coordinates and shares data with each patient’s physician, allowing clinicians to view measurement reports. This is a vital link in the information chain that has the potential to lead to better long-term health and lower long-term health care costs.
Members typically participate in the program for six to nine months, at which point they meet criteria for better managing their condition and living a healthier lifestyle. Once Humana sees evidence that patients have learned how to manage their conditions, patients “graduate” from the program and Humana personalizes the Guide for another CHF patient.
Recognizing the Potential to Reach More Patients
During the six month deployment period, 1,000 Guide units were deployed in 33 states. Now, CHF patients, even those living in remote areas, can receive personalized care and support in their homes, making it easier for these patients to comply with their treatment plan and manage their chronic condition.
The overall goal of the program is to increase patient self-management to improve health, reduce hospitalizations and ER visits, and lower health care costs. While it’s too early to quantitatively measure these results, Humana Cares is optimistic about the program’s effectiveness. High patient adherence and satisfaction rates indicate patients like the Guide and find it easy to use. Equally important, Humana Cares nurses report that the valuable, real-time information provided by the Guide enhances the effectiveness of their patient interactions.
Humana will fully evaluate the success of the program including ROI, admission and readmission rates for CHF patients, as well as ER visits for CHF patients. In addition, they will measure post-participation weight monitoring, member adherence, member satisfaction, device and peripheral replacement rates, and staff satisfaction, as well as overall program design. If the program proves to be successful, the company may launch similar programs for patients with other chronic conditions.
The Guide platform is designed to help address the many challenges that accompany chronic conditions. It is a comprehensive, remote health monitoring and management solution to help health care organizations and insurance providers more efficiently extend their services into homes, while engaging patients to create lasting lifestyle changes.