Presentation by Dr. Rajni Aneja, Strategic Executive and Clinical Transformation Leader, Humana, Inc, mHealth Israel conference, October 7th, 2013, Tel Aviv. Title is "The Future of Healthcare in America"

1. The Future of Health
Care In America
Tel Aviv
October 7,2013
Rajni Aneja MD
Strategic Executive, Clinical
Transformation leader
Humana Inc.

2. 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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3. Health care costs are burdening society
People are
getting older
People are
unhealthier
Structure is
flawed
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4. Doing nothing doesn’t work
Medical costs by age and risks
Annual medical costs
$7,000
$6,000
$5,000
$4,000
$3,000
$2,000
$1,000
$0
19-34
35-44
45-54
55-64
65-74
75+
High risk
Medium risk
Non participant
Low risk
Age range
Source: Edington, Zero Trends, 2009
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5. Consumers are empowered
Demand
easy
Connect
to many
Desire
customization
5

6. Demand
easy:
Quick, uncomplicated and no hassles
6

7. Connect
to many:
Enabled by technology
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8. Desire
customization:
Tailored to their desires
8

9. Leading companies evolve from transactions to experience
Why can’t health care?
9

10. Health care is evolving from sick care to health
Fee For Service
Employer /
Government-Based
Purchasing
Quality / Cost
Reimbursement Models
Consumer Choice
Industry Evolves from
Sick Care to Health
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11. The building blocks
Genetics
Intake
Prevention
Triage
Navigate
Dx
Rx
Environment
Maintain
Source: Presentation by Dr. David Lawrence at Clinical Care Forum 8/13
Behaviors
Rehab
Palliate
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12. Personalized quantitative disease progression
12
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13. Convergence of mobile, social, devices and analytics
Mobile
Mobile
Social
Personal Devices
Consumer Analytics
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14. The future is now
Medicare Advantage is a successful integrated care delivery model
5 million to 15 million
More seniors are choosing Medicare Advantage
Source: April 22, 2010 Letter from the CMS Office of the Actuary (total expected enrollments); Kaiser Family Foundation
(MAPD Penetration)
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15. Humana’s Integrated Care Delivery Model
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16. Building capabilities
•
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
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17. Simplicity that’s sustainable
Win-win partnerships
Providers
Government
Members
Employers
Integrated Care Delivery
Engaged in their health
Quality and
Cost Improvement
Productivity
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18. Thank You

19. Humana mHealth / Current Capabilities
MyHumana
•
MyHumana App
–
•
HumanaFit App
–
•
HumanaFit
Workflow optimization and enhanced communication
efficiency across caregivers, clients and their family
support network
SMS
–
•
Fitness and activity tracking
Caregiver App (“Betty”)
–
•
Member health and well-being management
Medication Adherence & Prescription Re-fill
Reminders, Account Balances, Health & Wellness Tips
Betty Caregiver App
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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