Now in the third year of its “Bold Goal” initiative to make the communities it serves 20% healthier by 2020, Humana’s leaders have learned plenty about social determinants of health and what they can do to tackle those challenges.
But while much of the work Humana and its partners have done so far has been around addressing food insecurity, lately it is also turning its focus to a different, perhaps less recognized issue: loneliness.
Pattie Dale Tye, Humana’s segment vice president, said the company has found that social isolation and loneliness is the No. 1 social determinant that impacts an individual’s number of “Healthy Days,” a metric developed by the Centers for Disease Control and Prevention that Humana uses to measure its initiative’s progress.
“That was a surprise that we uncovered in our work in the past year,” she said in an interview. “If you combine that with chronic disease or food insecurity, which is the No. 2 social determinant of health that we’ve found, you’ve really got an opportunity to step in and make a difference.”
The business case for better health
As it has worked with community partners to tackle various health issues, Humana has tried to make it clear that it these efforts are not just good for communities and healthcare providers—they’re also good business, said Chief Medical Officer Roy Beveridge, M.D.
“When we first started doing this, I think the skepticism from physicians was quite high, and the physicians basically all said, ‘hey, are you guys all from the Humana Foundation, is this philanthropic work?’” he said. “And the answer was no, it’s really not philanthropic work.”
“What we know for any of our members if we invest in their health, and they become healthier, then our costs decrease,” he added.
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In fact, people who are very socially isolated are associated with about $130 per month more in Medicare spending than their non- or less-isolated counterparts, according to a study from AARP. The problem is particularly acute for seniors, Tye noted.
First steps to address isolation
While Humana may have identified a pressing health issue that requires attention, it is just beginning to address what to do about it.
“We’re trying to figure out social isolation, to be blunt,” Beveridge said.
The insurer has started telephoning some of its members to learn more about “what would make a difference in loneliness in their world,” Tye said, adding that “then we’ll take that learning and help our physicians apply that learning when members come in for an office visit.”
And on a community level, Humana is uncovering opportunities to engage stakeholders around the subject. For example, it helped Louisville, Kentucky, which is overindexed for suicide compared to other cities, hold a summit on the topic that kick-started community-wide training to identify symptoms and fundraising walks.
“So you’ve had a real grassroots effort to recognize something that probably folks didn’t talk about in the past,” Tye said.
Communities make progress
Already, the Bold Goal initiative has achieved some promising results, according to a recent report from Humana. In 2016, two of Humana’s target communities—Knoxville, Tennessee, and San Antonio, Texas—showed substantial decreases in the number of “Unhealthy Days.” Another four had smaller decreases in Unhealthy Days, and one community saw a slight increase.
If there is one lesson that Humana’s work has underscored so far, it’s that it won’t be able to fix the problems that drive up health costs alone, Tye noted.
“These are tough issues; they take a system-wide approach to fix them,” she said. But “once we get folks to acknowledge that this is an issue, and a health issue, then people really do stand up.”