By Heather Landi, Fierce Healthcare | October 3, 2019
Insurance giant Humana operates a mail-order pharmacy, has more than 230 owned or alliance primary care clinics and a large home health care provider, Kindred at Home. And the payer continues to build out capabilities to address members’ social determinants of health.
These healthcare services are part of Humana’s shift from “an insurance company with elements of healthcare to a healthcare company with elements of insurance,” Vishal Agrawal, chief strategy and corporate development officer at Humana, said during CB Insights’ Future of Health event in Manhattan Wednesday.
“Parts of (these capabilities) we will own, as we’re building primary care clinics, but we’re also looking to stitch together other primary care innovators that believe in value-based care,” he said.
Innovative technology will be critical to help support these healthcare services, Agrawal said.
“We’re using technology to enable better care for members. We’re creating a holistic platform for our members, and Medicare Advantage is a financing model that helps to do that, and technology is a key enabler of that journey,” he said.
Last year, Humana announced it was launching a new digital health and analytics unit, Studio H, in Boston and tapped former financial technology executive Heather Cox as the company’s first chief digital health and analytics officer. The digital health hub has the look and feel of a tech startup. “It looks a little bit unlike other insurance companies, and or even like the rest of Humana. We’re excited about the space and it continues to grow,” Agrawal said.
Humana executives said last year that Studio H would focus on three areas of digital health: technology designed to manage provider workflow, expanding telehealth into the home health and primary care settings and bringing voice recognition tools to members in their homes.
Agrawal said Humana has built a team of data analysts and developers to help build digital products. The team already has helped build out one of Humana’s digital services—a new virtual primary care service launched with telehealth company Doctor on Demand. Called On Hand, the plan gives patients access to a dedicated primary care physician as well as preventive care, urgent care and behavioral health through video visits with lower monthly premiums.
The health insurer has been stepping up its efforts to use digital health and virtual care to improve care coordination and healthcare delivery. In June, Humana teamed up with digital health startup Aspen RxHealth to offer Medicare Advantage patients an app that connects them with pharmacists for clinical services, including medication therapy management.
Signaling its move deeper into healthcare technology, the payer also recently joined the Consumer Technology Association (CTA)—the first payer to so do—joining companies like Microsoft, Walgreens and Fitbit in the CTA’s digital health and fitness division.
Through its Studio H capabilities, Humana is looking to build a longitudinal health information record for members and patients, Agrawal said. “That’s not just clinical information but also social determinants of health information. We will then provide through open APIs (application programming interfaces) connections to those discrete data elements that can feed workflows that either we created or created by others who are innovating in various aspects of care delivery,” he said.
“That longitudinal record becomes a single source of truth and as we bring that together that will drive a lot of innovation at scale for our members,” he added.
As the line blurs between payer and provider, there’s a growing focus on holistic wellness, Agrawal noted. “We’re increasingly covering transportation needs, and needs around food insecurity and ensuring members have the ability to pay for prescription drugs,” he said.
Humana plans to use data analytics capabilities to better identify members’ social determinants of health needs. “Part of predictive analytics is getting close to the member. We’re partnering with organizations outside of healthcare where, with the member’s consent, we can identify information they are sharing with us. Proximity is the key to predictive ability,” he said.
The social determinants of health solutions market is fragmented now, Agrawal said. “We’re looking for something that integrates all that data but we’re also building our own solutions,” he said.
The work to address social determinants ties into Humana’s Bold Goal project, which aims to reduce unhealthy days by 20% by 2020. To date, Bold Goal communities have collectively cut down unhealthy days by 2.7% since 2015. Some communities have seen larger decreases; for example, members in San Antonio saw a 9.8% decrease.
When asked for his take on the most underrated and overrated healthcare trends and technologies, Agrawal said voice recognition was underrated: “It’s the original human operating system,” he said.
Interoperability? “I’m optimistic. I think it’s underrated.” And his take on value-based care—”It’s the future. It’s the model that enables everything.”