Insurance giant Humana has a pretty audacious goal: It wants the communities it serves to be 20% healthier by 2020. And to get there, it has realized it needs to address some issues that aren’t commonly discussed at healthcare industry meetings.
The company is using the CDC’s Healthy Days measure as its guiding metric. That measure asks, “In the last 30 days, how many have you been physically not well?” and “In the last 30 days, how many have you been mentally not well?” The correlation between the 2 is extremely strong, according to the insurer’s Bold Goal (Population Health) Director, Andrew Renda, MD.
To improve both mental and physcial health, Renda said that the company needs to focus on some surprising factors: namely, loneliness and food insecurity.
Food insecurity is surprisingly prevalent, and can lead to poor health. One in 8 Americans, and over 5 million seniors, face food insecurity. They’re 50% more likely to be diabetic, and 3 times more likely to be depressed as a result of the availability of healthy food.
“There’s a concept that food is medicine that has not been explicitly embraced by the government,” Renda said. Humana’s pipeline of food insecurity trials is meant to drive home the point that good food is vital to good health. They’ve launched numerous pilots around the idea. In 1 Florida study, they built a tool into physicians’ electronic medical record in a health system to allow them to ask patients about their access to healthy food. Humana expected 15% to say they were, but 46% did.
The alarming numbers helped spawn even more pilot programs, including randomized control trials and initiatives with Feeding South Florida. They even had a sort-of solidarity program in which Humana associates voluntarily live on SNAP benefit budgets for a week—roughly $4.50 for food per day.
The second major Bold Goal focus, loneliness, actually came up in a few earlier speeches at the Population Health Colloquium, where Renda was speaking—he jokingly thanked the other presenters for taking away many of his talking points. More than 40% of older adults report being lonely, and severe isolation has the same negative health impact as smoking 15 cigarettes per day, he said.
To learn more about the problem, his team contacted 100,000 Humana patients to ask about their level of isolation. Each point on the loneliness scale correlated with the healthy days scale, he said, meaning the loneliest people reported the fewest healthy days.
His team got 20,000 responses, allowing them to build rich predictive analytics tools to understand who would need intervention.
As it has with food insecurity, Renda’s team has brewed up an extensive pipeline of studies and interventions for loneliness. It has teamed with the National Coalition on Aging to further its work.
When he speaks of his work, Renda says people ask him if he is with the Humana Foundation or the company’s Office for Corporate Social Responsibility. “No, we’re with the Office of the Chief Medical Officer,” he said. “We expect an ROI for what we do.”
“Eventually, my team will go away. Every market, every city, will be thinking about this,” he said. Later this week, the team will release a progress report on its fast-approaching goals. Renda was slyly confident when he acknowledged that. “The future is bright,” he said.