Rajni Aneja MD Strategic Executive, Clinical Transformation leader Humana Inc.
The Future of Health Care In America Tel Aviv October 7,2013
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Humana background
• Fortune 100 company
• Founded in 1961
• Headquartered in Louisville
• $39 billion in annual revenues
• 49,000 associates
• 12 million medical members, 8 million specialty members
• Our dream: To help people achieve lifelong well-being
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Health care costs are burdening society
Structure is flawed
People are unhealthier
People are getting older
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$0$1,000$2,000$3,000$4,000$5,000$6,000$7,000
19-34 35-44 45-54 55-64 65-74 75+
Doing nothing doesn’t work Medical costs by age and risks
Low risk
Medium risk High risk
Non participant
Annual medical costs
Age range
Source: Edington, Zero Trends, 2009
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Consumers are empowered
Desire customization
Connect to many
Demand easy
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Demand easy:
Quick, uncomplicated and no hassles
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Connect to many:
Enabled by technology
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Desire customization:
Tailored to their desires
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Leading companies evolve from transactions to experience
Why can’t health care?
Fee For Service
Employer / Government-Based Purchasing
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Health care is evolving from sick care to health
Quality / Cost Reimbursement Models
Consumer Choice
Industry Evolves from Sick Care to Health
11 Source: Presentation by Dr. David Lawrence at Clinical Care Forum 8/13
The building blocks
Intake Triage Navigate
Dx Rx Maintain Rehab Palliate
Environment Behaviors Prevention Genetics
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Personalized quantitative disease progression
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Convergence of mobile, social, devices and analytics
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Social Mobile Mobile
Consumer Analytics Personal Devices
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The future is now Medicare Advantage is a successful integrated care delivery model
Source: April 22, 2010 Letter from the CMS Office of the Actuary (total expected enrollments); Kaiser Family Foundation (MAPD Penetration)
More seniors are choosing Medicare Advantage
5 million to 15 million
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Humana’s Integrated Care Delivery Model
• Primary care doctors with risk relationship to Humana – 4,200 affiliated/joint venture – 3,700 contracted – 270 employer-based worksite and occupational medicine sites
• Extended care capabilities (Humana Cares, American Eldercare)
– 9,000 dedicated doctors and nurses – 212,000 members in chronic care program
• Fourth-largest Pharmacy Benefits Manager – 240 million prescriptions processed – 20 million prescriptions dispensed
• Motivating/measuring wellness – 2.7 million HumanaVitality members
Building capabilities
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Simplicity that’s sustainable Win-win partnerships
Providers Integrated Care Delivery
Government Quality and Cost Improvement
Employers Productivity
Members Engaged in their health
Thank You
• MyHumana App – Member health and well-being management
• HumanaFit App – Fitness and activity tracking
• Caregiver App (“Betty”) – Workflow optimization and enhanced communication
efficiency across caregivers, clients and their family support network
• SMS – Medication Adherence & Prescription Re-fill
Reminders, Account Balances, Health & Wellness Tips
• Telehealth – Pilot project aimed at better care for members with
congestive heart failure • Bluetooth-enabled scales and blood pressure monitors,
linked to a cellular modem and Interactive Voice Response Technology
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Humana mHealth / Current Capabilities MyHumana
HumanaFit
Betty Caregiver App
