Contributors: Dr. Sandra Delgado and Pattie Dale Tye
To learn more about Sandra and Pattie Dale, click here.
Humana’s Bold Goal – to improve the health of the communities we serve 20 percent by 2020 because we make it easy for people to achieve their best health – has brought lasting and far-reaching improvements to multiple communities, with San Antonio leading the way.
In our last article, we talked about how the community has embraced our Bold Goal efforts and the early momentum we achieved. We’d now like to show the truly impressive gains made over the past year – with the help of our community and physician partners – in addressing the social determinants of health, like food insecurity, health literacy, and loneliness.
San Antonio, our first and most mature Bold Goal community, has experienced a 9 percent increase in the number of Healthy Days, surpassing our trajectory goal for 2017. Measuring Healthy and Unhealthy Days is a U.S. Centers for Disease Control and Prevention (CDC) tool that reveals how a person is feeling holistically, including his or her mental and physical health in a 30 day period. That 9 percent increase was particularly gratifying, given the CDC shows national Healthy Days have been flat for a long time. Specific to Humana members, we expected a flat trend for the first 2-3 years as we test and learn interventions, followed by a steeper increase in Healthy Days improvement over the final 3 years as we scale effective interventions through 2020.
The results in our 2017 progress report reflect wide-ranging collaboration in San Antonio between the San Antonio Health Advisory Board (HAB), which is made up of physicians, business leaders, non-profit organizations, government officials and public health organizations, and a Board of Directors, made up of Humana senior leadership. Such a wide range of partners is key, because health isn’t just about seeing a doctor once or twice a year. There are numerous environmental, social, psychological, and economic issues that impact a person’s health and are often the root cause of illness. Health can’t just be about reacting to disease; we have to be proactive in preventing disease and promoting well-being.
Realizing these external factors have profound effects on health, we are working with our community partners to address barriers like food insecurity and lack of access to behavioral health services, as well as health conditions like diabetes and depression.
A few examples of our pilots and interventions in San Antonio include:
- The Path to Wellness program, one of our longest-running collaborations in San Antonio, works with H-E-B grocery, the YMCA of Greater San Antonio, and primary care physicians (PCPs) at MCCI and Partners in Primary Care to address diabetes, nutrition, and health literacy. This program combines one-on-one nutritionist consultation and guided nutritional grocery store tours with a registered dietitian, as well as disease-specific education and physical activity measurement and education with the YMCA. The PCP and clinical staff support the patient throughout the program, through quarterly office and lab visits. We are measuring improvement in HbA1c, body mass index (BMI), and cholesterol.
- Our telepsychiatry pilot addresses a nationwide issue – the difficulty in getting timely, affordable, coordinated access to behavioral health services. Technology enables a behavioral health clinician to diagnose and treat a patient from a remote location. In partnership with Humana Behavioral Health and Humana Integrated Clinical Services, telehealth equipment (i.e., laptop, large monitor, and HD webcam) was embedded in Humana-owned clinics in San Antonio. Patients are evaluated and referred by their PCP, who facilitates the telepsychiatry visit and coordinates treatment with the behavioral health provider.
- Recently, the San Antonio Health Advisory Board and the American Diabetes Association developed a digital resource guide, offering people with diabetes and their caregivers new ways to manage the condition through a vast online network of programs and services. We are working with physicians to “prescribe” the resource guide as an additional tool for managing diabetes as well as mitigating diabetes in those residents who are most at risk.
- The San Antonio Health Advisory Board has joined with the San Antonio Parks and Recreation Department on Fit Pass, a reward-based program that encourages people to use the many available resources in San Antonio, including parks and walkways, to improve their well-being. Using a mobile app or the desktop version, users can engage in a free interactive fitness scavenger hunt to take part in wellness activities and earn points toward new bikes, personal fitness equipment, gift cards or other prizes. Humana Guidance Center classes that are part of the Fit Pass Program were filled to capacity in 2016, and there were 986 Humana Vitality beacon check-ins throughout the program; we placed beacons in 12 of the Fit Pass Program locations.
In large part, health happens locally and occurs outside of the clinical setting. By identifying the environmental, community-based elements that influence a person’s health, we can create more informed, localized solutions to influence lifelong well-being. Our commitment to physician and community-focused efforts contributes to improved clinical outcomes and more Healthy Days in San Antonio. Our wide-ranging partnerships have allowed us to leverage data and insights in new ways to improve population health.
As Humana’s first Bold Goal community of learning, San Antonio enables sharing of its experiences of building partnerships and planning health interventions with other communities including Tampa Bay, Broward County (Florida), New Orleans, Baton Rouge, Knoxville and Louisville. Each of these seven Bold Goal communities of learning has offered distinct insights, and the best ideas have been shared and implemented elsewhere. However, with its dramatic 9 percent increase in Healthy Days, San Antonio continues to be a Bold Goal community leader in collaboration and actionable insight.
Learn more about our Bold Goal progress in San Antonio and other communities at: humana.com/boldgoal