The Promise of Partnerships to Improve Health: An Update on Project San Antonio

partnership_san_antonio_photo.jpgContributors: Dr. Sandra Delgado and Pattie Dale Tye
To learn more about Sandra and Pattie Dale, click here

With America facing an epidemic of chronic diseases — with about half of all adults living with more than one chronic condition as of 2012 according to the CDC — research has shown the health of individuals relies in large part on the health of the communities in which they live.

Last year, we told you about the community of San Antonio, and the groups there who are bringing down barriers to health at the local level. Humana is trying to act as a facilitator in this community, connecting groups so they can do more together. It’s still early, but we’d like to update you on the progress they have made.

Where we began and how far we’ve come
The collaboration in San Antonio began in summer 2014 with a Clinical Town Hall. More than 100 participants attended from community groups and Humana. The Clinical Town Hall produced the San Antonio Health Advisory Board (SAHAB), made up of approximately 45 community members who influence health in San Antonio. They gather quarterly to co-create solutions that address the community’s biggest health barriers — such as nutrition, healthy behaviors, and health literacy — and figure out which solutions Humana can help support. As of our last article, SAHAB was setting up workgroups. These workgroups are now up and running, meeting biweekly or monthly.

One SAHAB workgroup is supporting the San Antonio Parks and Recreation Department to expand its Fit Pass program, a city-wide effort that gives people “passports” where they earn stamps when they complete physical activities. The SAHAB workgroup has helped build an iOS app to help people track their Fit Pass progress, which has already been downloaded more than 700 times, and they’re helping expand the program to give people incentives for getting regular health checks. Their collaboration has already produced results, with 12,208 passports distributed in 2015, compared with 8,812 in 2014. The return rate of completed passports was 45.7% in 2015, compared with 27.1% in 2014.

Another important partner is the Mayor’s Fitness Council, and one workgroup is developing a health resource guide the mayor’s office has pledged to put online. We’re also working with the San Antonio Food Bank to ensure those who rely on it have access to proper nutrition, and with the Bexar County Medical Society, which connects us to the clinical community in San Antonio. Another workgroup is helping the area’s Emergency Medical Services departments reduce the number of unnecessary calls to 911 by offering outpatient solutions for people who are overusing the system.

Early in this process, community groups told us that rather than begin new projects, they would prefer to have Humana work with them on what they were already doing. We’ve acted on their advice. We’ve made strides in health simply by linking and lifting existing projects and connecting local groups.

Progress from partnerships
When we began our work in 2014, we did a survey using the CDC’s Healthy Days measurement to establish a baseline for health. San Antonians reported, on average, 5.7 physically unhealthy days per month and 4.1 mentally unhealthy days. We conducted a second survey in 2015, and the results will soon be available. Based on the annual results, we plan to do regular surveys to measure our progress based on this Healthy Days measurement.

Other partnerships have advanced, too. Since our last article, we’ve moved forward in a partnership with H-E-B, the largest grocery chain in Texas. We began the partnership more than a year ago by focusing on our 1,700 employees in the San Antonio area. H-E-B held events at which their nutrition experts gave employees tours of the healthy food in the store and did healthy cooking demonstrations.  In a survey of participants, 100% of the 82 respondents said the store tour had changed their thinking about food, and 69% said they substituted the healthy meal for eating out. The program with our employees was a success; its next phase will be expanded to Humana members and patients of Humana’s physician partners in the area. In one of our San Antonio Guidance Centers, we’ve begun H-E-B store tours, led by nutritionists who also teach members to shop using healthy recipes. Physician partners can also write “prescriptions” for nutritional counseling at H-E-B stores. We’re currently experimenting with a new program that gives employees incentives to purchase healthy foods at H-E-B.

Next Steps
Despite this early progress, there’s still more to be done. In the coming months, we want to address mental health in addition to physical health. In 2016, we’ll build seven telepsychiatry centers in primary care physicians’ offices. Patients will have direct access to psychiatric consults without having to leave their clinician’s office.

We also continue to look for additional health-minded partners with whom to connect on the SAHAB. Its early successes have brought the SAHAB to the attention of even more community groups who are interested in collaborating.

Above all, over the next few years, we’ll look to replicate the work we’re doing in the San Antonio community in cities around the U.S. In fact, Humana took this concept to six other markets in 2015: Louisville, Ky.; Knoxville, Tenn.; New Orleans, La.; Baton Rouge, La.; Tampa, Fla., and Broward County, Fla. We’re documenting everything we do in these cities, so we can share best practices and adapt them to the particular needs of each city. That includes our successes, as well as the questions we’re still grappling with, such as, “How do we keep momentum for the long term?”

San Antonio is an incubator, where bold ideas are birthed and we learn from our successes and our failures. The work our partners are doing in San Antonio is already changing lives for the better, and we’re capable of even more in the future.

Contact Dr. Sandra Delgado at: 
Contact Pattie Dale Tye at: