Humana 2010 Annual Report Download - page 6
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Improving Outcomes and Lowering
Costs for Our Medicare Members
Whatever else it might have done or will do,
last year’s health insurance reform debate put
the spotlight on the nation’s rising healthcare
costs, especially in Medicare, and on the
growing incidence of expensive and largely
preventable chronic diseases.
That cost growth is unsustainable.
Unless consumers are engaged in
their health, and unless companies
like ours with a track record of
success in consumer engagement
continue to offer attractive programs
that make healthy things fun and
fun things healthy, a crisis will soon
be upon us.
We are doing what we can to
mitigate such a crisis and, for own
members, seeing good results.
Favorable comparisons versus
traditional Medicare in such
important measures as hospital
admissions, readmissions, and
emergency room use are the
result of an integrated member-
and physician-focused services
program that simply does not
exist in traditional Medicare.
We believe that the consequence is
better health outcomes and quality
of life for our members, along with
lower costs compared to seniors in
traditional Medicare. The program
begins with health risk assessments
of new members and follows that
up, where warranted, with proactive
outreach for clinical guidance.
This outreach can be in the form
of personal nurses, chronic care
management programs, integrated
medical and behavioral health, or
hands-on assistance with feeding,
bathing, and other key components
of daily living. There are also a wide
variety of healthy living and healthy
eating options available to members,
health and wellness classes, and a
variety of plan-based and community-
based support services for our most
at-risk members through our Humana
Cares program.
As it evolves, our clinical program is
increasingly aligned with CMS’ Star
rating system in anticipation of
coming changes in the Medicare
Advantage revenue model. Such
alignment has already yielded
progress. From 2010 to 2011,
Humana’s Star rating summary score
improved from 2.74 to 3.11 stars.
For the 30 Humana plans rated in
both years, 17 plans improved their
Star ratings, 13 remained constant,
and none experienced a decrease.
5 2010AnnualReport
Unless consumers
are engaged in their
health, and unless
companies like ours
continue to offer
attractive programs
that make healthy
things fun and fun
things healthy, a crisis
will soon be upon us.