Innovating and adapting in an ever-evolving healthcare system

The healthcare system is constantly evolving. There are many different things happening each day that make us better at delivering high-quality care to our members and patients and demonstrate that we are putting their health first.

We all know the healthcare system can feel complicated for those using it. It’s what happens behind the scenes that makes all the difference. We must constantly push ourselves to find innovative ways to simplify processes for care delivery and payment that will improve the experience of our members and patients as well as our partners. I believe we are doing that at Humana .

Value-Based Care

From a clinical perspective, how we deliver care and the partners we work with have a direct impact not only on the experience of our members and patients but also on their health outcomes. We have seen tremendous growth in value-based care over the last decade with 2.3 million more patients receiving care in this type of arrangement.

As Humana’s Chief Medical Officer Dr. Kate Goodrich recently outlined, our focus on integrated, value-based care enables us to care for the physical and mental health of our members and patients while also addressing social and environmental factors that can affect their health. Our data from 2022 shows significant cost savings for our members in value-based care arrangements – an average of 23.2% savings in medical costs compared to individuals enrolled in Original Medicare.

Interoperability

Interoperability is also critical to the future success of our business and the industry as a whole. If you have had personal interaction with me, you know it is something I talk about often. We have made great strides in technology designed to increase access to quality care and improve health outcomes for our members and patients. This is a continuously evolving process to simplify and automate the sharing of information between payers, providers and members. Access to on-demand medical records not only reduces wait times and decreases waste in the system, it also helps facilitate safer and more coordinated, patient-centered care.

Interoperability allows physicians to make determinations regarding treatment faster and easier, and it allows us to deliver better value for our business and our partners. In fact, a 2023 assessment showed an estimated $600 million in total value created by interoperability solutions. Interoperability is a win-win. Increasing provider use of automated tools helps us deliver better care for our members and patients and also better value for our businesses and partners.

Quality

Quality is another topic you will hear me talk about constantly, and with good reason. Humana is a leader in the industry because we are meticulous about the quality of the services we provide our members and how we support the healthcare practitioners in our networks. With 94% of our Medicare Advantage members enrolled in plans rated 4+ stars by the Centers for Medicare & Medicaid (CMS) in 2024, we have demonstrated that we care about quality and are dedicated to having a positive impact on the health and well-being of our members.

When you boil it down, what this means is that our members are engaging with their physicians, they are taking their prescribed medications, and they are getting important screenings. For example, 77% of our Medicare Advantage members are up to date on recommended colon cancer screenings, and 88% of members who need medication to help manage their cholesterol are taking their meds as prescribed. When patients are seeing their medical providers regularly and following their guidance, it results in better health outcomes – and that’s exactly what we are trying to enable.

In addition to value-based care, interoperability and quality, we are producing actionable research, holding ourselves and those we do business with to high standards of excellence, building a diverse supply network, and so much more. To learn more, read the recently published 2023 Humana Impact Report.