Humana to pilot new tech-enabled chronic care management platform

Humana is launching a pilot for a new, tech-enabled chronic care management platform.

Humana Care Support will harness enhanced data analytics to create an integrated, personalized experience for members, the company said in an announcement provided first to Fierce Healthcare.

The program will also offer members with chronic illnesses access to a multidisciplinary care team to address their individual needs. The team includes a nurse, a pharmacist, a social worker and a behavioral health expert, Humana said.

The model is designed to integrate the social determinants of health and value-based care into its personalized approach, according to the announcement.

The insurer intends to pilot the platform for Medicare Advantage members with multiple chronic diseases, congestive heart failure and diabetes in Pennsylvania, West Virginia and Kentucky. It plans to grow the program further over the course of 2021.

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William Fleming, segment president of clinical and pharmacy solutions at Humana, told Fierce Healthcare that the new pilot represented an opportunity for the insurer to update its approach to chronic care management.

"We recognized that there were a few things we needed to modernize in how we're approaching our work with them," Fleming said.

Humana Care Pilot is built on Salesforce's Health Cloud platform, which allows the care team to access a single view of the member's full medical history and any integrated clinician workflows. Analytics are backed by Microsoft's Azure and Power BI to provide actionable data insights on the member's health, the insurer said.

Humana announced in September that it was working with Salesforce on a new care management platform, and in 2019 it inked a seven-year deal with Microsoft to provide predictive data solutions to its care teams.

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While the platform was in the works before COVID-19, Fleming said the mindset behind it was critical to Humana's response to the pandemic.

The insurer was able to narrow down quickly and early which member populations were at highest risk due to the virus and track those who were hospitalized to monitor their health in an individual way, he said.

The pandemic further highlighted the fact that members now expect this level of personalization in their care, Fleming said.

"You want to know you matter," he said. "If we have knowledge about you, it's clear consumers expect us to use that knowledge."