Once we establish roots and networks into a community, grow our membership, and employ our strategy of deep community involvement in addressing health-related social needs, members are more likely to get the resources they need to improve their quality of life.
Our clinical operating model has evolved to fully incorporate social determinants of health. Our associates, especially those who interact with members every day – case managers, physicians, nurses, pharmacists, sales representatives, customer service operators and others – value taking care of the whole person. Many are screening members every day and referring them to appropriate social support resources.
We stepped back and took a hard look at how we worked. We created synergies between our clinical, data, policy, product and research departments to streamline our work, improving the coordination to support members and the physicians and other clinicians who care for them. We applied our learnings in our original seven Bold Goal communities and have grown to 16 designated Bold Goal communities.
Bold Goal Communities
As an industry influencer, we exchange learnings with policymakers, state and local government officials and peers to better understand what will help improve care, while also reducing waste and avoidable costs. This is done through eliminating redundant testing, improving health education and communications, streamlining processes and keeping people out of the hospital and in their homes where they prefer to be.
Explore the Issue Briefs
Understanding our members’ most important needs and connecting them to the resources they need to navigate the complex health ecosystem are key to helping our members live their healthiest lives. To that end, Humana is investing in systems that support clinicians and social workers in referring patients to social outreach agencies, closing the loop with the resources.
Clinical Integration
Humana is invested in making sure members get the services they need to improve their health and well-being and integral to that mission is a way to inventory and respond to those needs.
In this last year, we’ve begun working with what we call SHARPs, which stands for Social Health Access Referral Platforms. There are different purveyors of these kinds of platforms, but they have similar functions. They provide a technology platform to connect key community health organizations to the most critical social health resources within their communities in a seamless, measurable way.
The association between health-related social needs and health outcomes has created opportunities for clinicians, case managers, social workers, community based organizations and staff to screen for social determinants of health, such as loneliness and food insecurity. When these needs are identified, and resources need aligned, a SHARP can be used as the next step in getting people the appropriate referral.
Focus on Screenings
We can only address needs when we know they exist. Thus, we set a goal in 2019 of completing one million screenings for social needs within our member population, and we far exceeded that goal by completing more than 2.5 million SDOH screenings. We found many members have more than one social need. Because health is complex and multi-faceted, we are committed to learning and doing more.
Scalable solutions
Bold Goal communities began with a test and learn approach to improve population health through partnerships and cooperative interventions. In 2019, we saw continued maturation of promising programs, and we expanded successful pilots into new markets where they could benefit more members.
As the coronavirus (COVID-19) response continues to evolve, we’re updating this page to share timely information and resources with you and the community you support.