Data pinpoints community health needs

Roy Beveridge

Population health management is hardly a new field for Humana, as it has been working in the space for 30 years, Chief Medical Officer Roy Beveridge tells FierceHealthPayer.

“We’ve been in the value arena now for a [long] time, and when you’re in a value arena you are by definition taking responsibility for a population’s health,” he says.

During that time, Humana has learned that population health requires more than just “writing checks out to the providers,” Beveridge says. The insurer also cannot improve the health of local populations on its own, and therefore must partner with local governments, hospital systems, nonprofits and other organizations to take a coordinated approach.

Pattie Dale Tye

Such was its strategy in an initiative that aims to make the communities it serves 20 percent healthier by 2020. In addition to working with community partners, Humana uses data analytics to better understand what’s getting in the way of healthy communities, Pattie Dale Tye, a segment vice president for Humana, tells FierceHealthPayer.

That includes not only using its own vast array of claims data, but tapping into other data sources as well, she notes.

Humana built a tool as part of a partnership with the nonprofit Robert Wood Johnson Foundation that allows it to look at ZIP code-level statistics that inform some of the social determinates of health, such as food insecurity and access to care.

In San Antonio, for example, Humana discovered that throughout the community there was a lack of access to behavioral health resources, Tye explains. To solve the problem, the insurer worked with its own network of providers, the city and other stakeholders “to bring more providers into play” and put tele-psychiatry programs into place.

Humana also uses data analytics to help primary care physicians act as “quarterbacks” for patient care by seeing all interactions with the health system that happen outside their office, according to Beveridge. The key, he says, is to make sure clinicians can see the data promptly and act upon it, which requires that it be in an “easy, palatable form that they don’t have to go into five other screens to get.”

Thus, Humana ensures that its analytics tools “hook into” the electronic health system of providers and provide alerts and information bilaterally.

“If you keep it on a separate system outside their workflow, it become increasingly difficult for physicians to toggle back and forth in different systems,” Beveridge says.

Data pinpoints community health needs

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