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Analysis of the 2019 Medicare Trustees' Report

Posted by www.psmbrokerage.com Admin on Thu, May 16, 2019 @ 11:18 AM

Analysis of the 2019 Medicare Trustees' Report

The Medicare Trustees have released their 2019 report, which makes projections for Medicare spending and revenue for the next 75 years. The Trustees expect Medicare spending to grow significantly over the next few decades. The Hospital Insurance trust fund for Part A is projected to be exhausted in seven years, and continued growth faster than the economy in Parts B and D is expected to put pressure on beneficiaries and the budget.

Highlights of the report include:

  • The Trustees project Medicare spending will increase from 3.7 percent of Gross Domestic Product (GDP) in 2018 to 5.0 percent in 2028 and 5.9 percent by 2040. Spending will continue to increase after that but more slowly, reaching 6.5 percent in 2090.
  • Spending growth is driven by both increased enrollment and per-person spending. Medicare enrollment is expected to grow by 27 million -- from 60 million to 87 million -- between 2018 and 2040, while per capita-spending is expected to grow faster than the economy over the next quarter century.
  • Each part of Medicare will grow: Part B experiences the largest increase as a percent of GDP while Part D is the fastest-growing part of the program.
  • The HI trust fund is expected to be insolvent by 2026 (unchanged from last year). The trust fund's 75-year actuarial shortfall is 0.91 percent of taxable payroll, meaning it would take about that much of a payroll tax increase or an equivalent amount of spending cuts to maintain solvency over 75 years.
  • Overall, the Trustees' report shows modestly higher spending relative to last year's report. Medicare spending will reach 6.5 percent of GDP by 2090 compared to 6.2 percent in last year’s report.
  • Medicare Advantage (MA) - private plans that provide Medicare coverage - is expected to continue to play a growing role in Medicare. MA enrollment is expected to increase from 37 percent of Medicare enrollment in 2018 to 40 percent by 2028, and spending will rise from 31 to 37 percent of Medicare spending.
  • An illustrative alternative scenario assuming certain payment policies the Medicare Chief Actuary views as unsustainable are rolled back would result in Medicare spending rising much faster, to 8.8 percent of GDP by 2090.

The Trustees show Medicare spending is projected to increase significantly as a share of GDP over the next few decades, with each part of Medicare contributing to the cost growth. In addition, lawmakers face a near-term financial challenge as the HI trust fund will be exhausted by 2026, just seven years from now. Lawmakers need to undertake reforms to Medicare to contain spending growth and ensure HI solvency.

Medicare Spending Is Growing Rapidly

As a share of GDP, gross Medicare spending is expected to grow significantly over the long term, especially over the next few decades.

The Trustees project gross Medicare spending will rise from 3.7 percent of GDP in 2018 to 5.0 percent in 2028 and 5.9 percent by 2040. Spending will continue to increase after that but more slowly, reaching 6.5 percent by 2090.

Medicare Part A is largely financed by a payroll tax, and other parts of Medicare are partially financed through beneficiary premiums. Net of these and other funding sources, spending is lower but still expected to grow significantly from 1.6 percent of GDP in 2018 to 2.6 percent in 2028 and 3.3 percent in 2040 before growing more slowly to 3.5 percent by 2090.

fig 1 medicare trustees 2019

The aging of the population is the primary driver of Medicare cost growth, particularly over the next few decades. The number of Medicare beneficiaries has already grown from 40 million in 2000 to 60 million in 2018 and is projected to grow by another 27 million (to 87 million) by 2040.

Per-capita increases in health care spending also play a role in Medicare spending increases, as nominal per-person Medicare spending is expected to increase by 65 percent – from $13,665 to $22,546 – between 2018 and 2028. This increase is larger than the 56 percent growth in the economy that is expected to occur over the same time period.

All Parts of Medicare Are Growing

The Medicare program comprises three main components: Part A covers inpatient care in hospitals and other facilities, Part B covers physician and outpatient care, and Part D covers prescription drugs.

Part A spending is projected to increase from 1.5 percent of GDP in 2018 to 2.2 percent in 2040 before growing more gradually to 2.3 percent by 2090. Part B follows a similar but faster-growing trend, increasing from 1.7 percent of GDP in 2018 to 3.0 percent in 2040 and 3.1 percent by 2090. Part D is the smallest but fastest-growing over the next 75 years, rising from 0.5 percent of GDP in 2018 to 0.8 percent in 2040 and 1.1 percent in 2090.

fig 2 medicare trustees 2019

Part A is financed primarily by a payroll tax paid into the Hospital Insurance (HI) trust fund, while Parts B and D are financed by general revenue contributions and premiums paid by beneficiaries to the Supplementary Medical Insurance (SMI) trust fund. Because of these differences in financing, the implications for growth in Medicare spending differ across trust funds, requiring different metrics to assess their status. Importantly, if the HI trust fund becomes insolvent, payments for benefits in Part A of the program will be reduced to match income. Policymakers would need to act to avoid disruption.

For the SMI trust fund, general revenue contributions and beneficiary premiums are set annually to cover program costs so the trust fund is always solvent by definition. Nevertheless, spending for Parts B and D is expected to grow significantly relative to GDP, putting pressure on the federal budget and on beneficiaries through higher premiums and out-of-pocket costs.

The Hospital Insurance Trust Fund Is Seven Years from Insolvency

The Trustees project the Part A Hospital Insurance (HI) trust fund will be exhausted in 2026, just seven years from now. At that time, spending would have to be reduced by 11 percent to be brought in line with revenue.

fig 3 medicare trustees 2019

The HI trust fund faces a 75-year shortfall equal to 0.91 percent of payroll, meaning it would take a payroll tax increase of about that size or an equivalent spending cut to keep the trust fund solvent. The shortfall is 19 percent of 75-year spending and 23 percent of 75-year revenue.

Both HI spending and revenue are expected to increase over time as a share of payroll, but spending will grow much more rapidly in the next few decades. HI spending will increase from 3.4 percent of payroll in 2018 to 4.2 percent by 2028 and 4.9 percent by 2040 before growing more slowly to 5.3 percent by 2090. Revenue will grow steadily from 3.3 percent in 2018 to 3.6 percent in 2028, 3.8 percent in 2040, and 4.4 percent by 2090.

Part B and D Spending Growth Will Put Pressure on the Budget

The Trustees project that both Parts B and D will grow faster than the economy because of growth in the eligible population and in spending per eligible beneficiary. As pointed out above, these parts are financed by general revenue as necessary, so they can’t become insolvent but their growth has other implications. The Trustees point out that absent changes in law, the growth in spending will require a growing share of federal income tax revenue and premiums and out-of-pocket spending will make up a growing share of beneficiary income.

The Trustees project spending for Parts B and D will increase from 2.1 percent of GDP in 2018 to 3.7 percent by 2040. We estimate this increase in program spending will cause beneficiary out-of-pocket costs to increase from 1 percent of GDP in 2018 to 1.8 percent by 2040.

fig 4 medicare trustees 2019

Medicare’s Outlook is Somewhat Worse than Last Year

This year's Trustees report shows a somewhat more challenging financial outlook for Medicare than last year's. The Hospital Insurance trust fund is still projected to be exhausted in 2026 as it was last year, but the 75-year shortfall has increased slightly, from 0.82 percent of payroll to 0.91 percent. The increase is attributed to higher spending and lower revenue than expected in 2018, lower economy-wide productivity growth (which results in higher payment growth), lower interest rates, and slightly higher private plan participation, partially offset by lower skilled nursing facility utilization.

fig 5 medicare trustees 2019

Medicare spending as a whole is also expected to be higher, particularly over the very long term. Projected spending in the 2019 report is within 0.1 percent of GDP of last year's report through mid-century, then the gap slowly widens to 0.3 percent of GDP (6.5 percent compared to 6.2 percent) in 2090. The Trustees attribute these differences to the aforementioned lower productivity growth -- which is used to reduce payment rates so lower growth results in higher payment growth – and increased growth in physician-administered drug spending. On the other hand, Part D spending is expected to be slightly lower due to higher rebates and slower drug price increases in the near term.

fig 6 medicare trustees 2019

Medicare Advantage Growth Will Continue

Medicare Advantage, the system of private health plans that operates in parallel to "traditional" Medicare, has taken on a greater role in the program over time. Participation increased from 24 percent of total Medicare enrollment in 2009 to 36 percent in 2018 with Medicare Advantage plans receiving more than three-quarters of the net increase in enrollment during that time.

The Trustees expect this trend to continue, though somewhat more slowly. Private plans are expected to receive a majority of the net enrollment increase over the next decade, with private plan enrollment reaching 40 percent of total enrollment in 2028. Per-person spending is expected to increase by three-quarters over the next ten years, from about $11,000 in 2018 to over $19,000 in 2028, slightly faster than the 65 percent growth for overall Medicare per-person costs.

Combining these two trends, total Medicare Advantage spending is expected to increase by 150 percent between 2018 and 2028, from $234 billion to $589 billion, compared to 111 percent for Medicare overall. As a share of total Medicare spending, it will rise from 31 percent to 37 percent. These projections show the Trustees expect Medicare Advantage to continue to play a big and increasing role within Medicare.

fig 7 medicare trustees 2019

Actual Spending Growth Could Be Worse

The Trustees' default projections assume current law, which means no changes are made to how Medicare operates. However, certain payment policies intended to hold down costs may be financially unsustainable and threaten access. Under its default projection, the Trustees expect Medicare inpatient hospital payments to fall from 60 percent of private insurance levels to about 40 percent in 75 years and for physician payments to fall from about 75 percent to 23 percent. Since 2011, the Chief Actuary of Medicare has published an Illustrative Alternative Scenario that assumes some of the policies that result in these low payment levels are rolled back.

The alternative scenario makes different assumptions from current law for three policies: the productivity adjustments that reduce certain payment updates by economy-wide productivity growth, relatively slow payment increases for physicians, and the expiration in 2025 of 5 percent bonuses for physicians who participate in alternate payment models. They assume the productivity adjustments are phased out, physician payments increase more rapidly, and the bonuses continue.

With these assumptions, the HI trust fund shortfall nearly doubles to 1.74 percent of payroll, and Medicare spending rises to 8.8 percent of GDP by 2090 instead of 6.5 percent. Most of the difference in spending emerges over the very long term as the higher payment increases compound over time.

fig 8 medicare trustees 2019


The 2019 Medicare Trustees’ report shows Medicare spending rising rapidly as a share of GDP over the next quarter century and the HI trust fund becoming insolvent by 2026. The illustrative alternative scenario that includes potentially more realistic payment policies shows Medicare spending rising even more substantially over the long term. Either scenario shows a situation where the federal government and Medicare beneficiaries will need to dedicate a growing share of their budgets to Medicare over time.

Lawmakers need to ensure the solvency of HI in the near term and should work at the same time to constrain spending growth in all components of the program. Doing these things will be key to securing our fiscal future.

Source: https://www.crfb.org/papers/analysis-2019-medicare-trustees-report

Image: www.Canva.com

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Tags: Medicare

Humana Plan Year 2020 Certification and Recertification Details Announced!

Posted by www.psmbrokerage.com Admin on Tue, May 14, 2019 @ 10:04 AM

Humana Certification & Recertification Course Details for Plan Year 2020!

Humana 2020 Certification Info Header

It’s already that time of year to start preparing for AEP 2020 and Humana is here to help. We are excited to announce that we will be launching certification and recertification courses earlier than ever before this year! Both courses will launch at noon Eastern Time on June 25, 2019

Our team listened to your feedback and has made some changes to help improve your experience this year.

Top 4 Improvements:

  1. This will be the earliest cert and recert launch date in Humana MarketPoint history!
  2. Certification Course outlines will be reduced by almost half while maintaining training quality and making it more efficient for you to complete your certification.
  3. Both the certification and recertification final exams are open book, and for PY20 we are making it easier than ever to find the information you need to pass the test.
  4. The time to complete the final exam (both cert and recert) will be extended from 35 minutes to 45 minutes

Certification & Recertification Launch Dates
All PY20 Certification and Recertification courses will launch Tuesday June 25, 2019 at noon EST.*

*NOTE: Does not include Spanish translation.  Spanish versions will be available on a delayed basis. Look for additional communications on Spanish versions.

Recertification Completion Deadlines

  • Internal agents will have until 5:00 PM Eastern time on September 30, 2019 to complete Recertification.
  • External agents will have until 5:00 PM Eastern time on November 30, 2019 to complete Recertification.

Ahip Information


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Tags: Humana, Medicare Advantage, Medicare, certification

64% Of Agents Report Increased Medicare Supplement Sales

Posted by www.psmbrokerage.com Admin on Wed, May 08, 2019 @ 08:36 AM

64 Of Agents Report Increased Medicare Supplement Sales

Nearly two-thirds of insurance agents reported increased sales of Medicare supplement insurance in 2018 and a higher percentage expect continued growth in 2019, according to a survey conducted by the American Association for Medicare Supplement Insurance.

"The vast majority of agents (64.1%) experienced increased Medigap sales in 2018 compared to the prior year," reports Jesse Slome, director of the association.

The organization polled 1,000 insurance professionals who market Medicare insurance in advance of the association's national Medicare Supplement industry conference. Over 300 agents completed the survey questions.

Some 64.1 percent of the agents reported increased or higher sales of Medigap insurance in 2018. Just over one-in-four (27.2%) indicated that their sales were about the same as the prior year with only 8.7 percent reporting decreased or lower sales.

The association asked agents to predict their 2019 sales compared to 2018.

"An ever greater majority of agents (68.6%) were more optimistic that their Medigap sales during the year would be higher," Slome said. "The percentage who expect decreased sales dropped to 3.8 percent.

"With 11,000 Americans turning 65 daily, it's no wonder why more agents are focusing on selling Medicare Supplement and Medicare Advantage products," he added. "There is every reason to be optimistic about the future and the continued growth of the industry."

Source: https://insurancenewsnet.com/innarticle/nearly-65-of-agents-report-increased-medicare-supplement-sale

Image: www.Canva.com

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Tags: Medicare Advantage, Medicare, Medicare Supplement

Industry Updates: Medicare Supplement Market Premium Grows 4.9% to $32.4 Billion

Posted by www.psmbrokerage.com Admin on Tue, May 07, 2019 @ 04:04 PM

CSG Actuarial Blog Header

By Taylor McDonald – CSG Actuarial – May 7, 2019

CSG Actuarial, with information from the NAIC and other sources, reports total earned premiums in the Medicare Supplement market in 2018 totaled $32.4 billion, a 4.9% increase over 2017. The total Med Supp lives covered in 2018 increased to 14.05 million, up 3.9% from 2017. The top 12 carriers in terms of 2018 Medicare Supplement premiums were:

1 United Healthcare
2 Mutual of Omaha
3 Anthem
5 CVS Health
6 Cigna 
7 CNO Financial
8 BCBS of Massachusetts
9 Humana
10 Wellmark
11 BCBS of Michigan 
12 BCBS of Florida

The 2018 overall Med Supp market loss ratio of 79.0% reflects a continued trend in the market of the overall loss ratios creeping back up towards “Pre-Modernized” levels of around 80%.

Source: https://www.csgactuarial.com/2019/05/industry-updates-medicare-supplement-market-premium-grows-4-9-to-32-4-billion/

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Tags: Humana, Cigna, Medicare, Medicare Supplement, UnitedHealthcare, CSG Actuarial, aetna, mutual of omaha

Medicare spending lower among seniors who switch to Medicare Advantage

Posted by www.psmbrokerage.com Admin on Tue, May 07, 2019 @ 01:43 PM

Medicare spending lower


By Shelby Livingston – ModernHealthCare – May 7, 2019

The health insurance industry often attributes lower spending among Medicare Advantage seniors compared with those in traditional Medicare to care management strategies. But a study published Monday turns that claim on its head.

Researchers at the Kaiser Family Foundation found that traditional Medicare beneficiaries who opt to enroll in a Medicare Advantage plan offered by a private health insurer have lower average spending and use fewer services—before they ever switch to Medicare Advantage—than their counterparts who stay in traditional Medicare. The findings raise questions about how much Advantage plans actually lower spending.

Moreover, the results suggest that the CMS, which uses traditional Medicare spending to calculate Advantage payments, overpays Medicare Advantage plans to the tune of billions of dollars each year, the researchers concluded. A little more than a third of the 60 million Medicare enrollees are in an Advantage plan. The CMS paid Medicare Advantage insurers about $233 billion in 2018, a figure expected to grow as more seniors choose Advantage plans.

"Medicare Advantage plans are perhaps getting paid more than the actual expected costs of their enrollees," said Gretchen Jacobson, a Kaiser Family Foundation associate director who co-authored the study.

Researchers looked at average Medicare Part A and B spending among people who were enrolled in traditional Medicare in 2015. Those enrollees who switched to a Medicare Advantage plan in 2016 spent $1,253 less in 2015 on average than beneficiaries who did not switch, after controlling for health risks.

Source: https://www.modernhealthcare.com/insurance/medicare-spending-lower-among-seniors-who-switch-medicare-advantage

Image: www.Canva.com

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Tags: Medicare Advantage, Medicare

Are Medicare Advantage Plans Lowering Medicare Spending?

Posted by www.psmbrokerage.com Admin on Tue, May 07, 2019 @ 11:23 AM

Are Medicare Advantage Plans Lowering Medicare Spending-2

Answer: Yes! 

By the Kaiser Family Foundation – May 7, 2019

People on Medicare can choose coverage from either traditional Medicare or Medicare Advantage plans, typically trading off broad access to providers for potentially lower premiums and out-of-pocket costs. Beneficiaries who choose Medicare Advantage may differ from those in traditional Medicare in both measurable and unmeasurable ways, which may influence their use of services and spending. Yet, Medicare payments to Medicare Advantage plans per enrollee are based on average spending among beneficiaries in traditional Medicare.

This analysis looks at whether beneficiaries who choose to enroll in Medicare Advantage plans have lower spending, on average – before they enroll in Medicare Advantage plans – than similar people who remain in traditional Medicare. We compare average traditional Medicare spending and use of services in 2015 among beneficiaries who switched to Medicare Advantage plans in 2016 with those who remained in traditional Medicare that year, after adjusting for health risk. We adjust Medicare spending values for health conditions and other factors, with a model similar to the CMS HCC Risk Adjustment Model that is used to adjust payments to Medicare Advantage plans (see Methods).

Key Findings

  • People who switched from traditional Medicare to Medicare Advantage in 2016 spent $1,253 less in 2015, on average, than beneficiaries who remained in traditional Medicare, after adjusting for health risk (ES Figure).

ES Figure: Traditional Medicare spending was $1,253 lower for beneficiaries who switched to Medicare Advantage in 2016 than for those who did not switch

  • Even among traditional Medicare beneficiaries with specific health conditions, those who shifted to Medicare Advantage in 2016 had lower average spending in 2015, including people with diabetes ($1,072), asthma ($1,410), and breast or prostate cancer ($1,517).

Even after risk adjustment, the results indicate that beneficiaries who choose Medicare Advantage have lower Medicare spending – before they enroll in Medicare Advantage plans – than similar beneficiaries who remain in traditional Medicare, suggesting that basing payments to plans on the spending of those in traditional Medicare may systematically overestimate expected costs of Medicare Advantage enrollees.

View Briefing

Source: https://www.kff.org/medicare/issue-brief/do-people-who-sign-up-for-medicare-advantage-plans-have-lower-medicare-spending/

Image: www.Canva.com

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Tags: Medicare Advantage, Medicare

Virtual Care for Medicare Advantage

Posted by www.psmbrokerage.com Admin on Tue, May 07, 2019 @ 11:02 AM

Virtual Care for Medicare Advantage

By TeladocHealth – May 6, 2019

Under the Centers for Medicare & Medicaid Services (CMS) proposed rule issued on October 26, 2018, Medicare Advantage plans will be able to provide “additional telehealth benefits” as basic benefits for purposes of bid submission and payment by CMS beginning in the 2020 plan year. With this landmark regulatory shift that expands reimbursement for virtual care services, CMS has opened the door for the advancement of differentiated offerings reliant on innovative care models.

A comprehensive virtual care strategy provides a pathway for health plans to expand their Medicare Advantage offerings by:

  • Expanding access to high-quality, comprehensive clinical care to more members
  • Better engaging members to enhance and simplify their healthcare experience
  • Delivering better data integration and care coordination
  • Connecting members with a broader network of providers and referrals
  • Improving clinical quality and Star Ratings


Medicare Advantage represents a significant growth opportunity for health plans serving the 65-plus consumer population. Recognizing the expansive and changing needs of this group—the “age-ins” along with the older demographic—the most-successful health plans will pivot quickly to partner with a trusted and proven virtual care provider to unlock value by incorporating comprehensive, scalable, and innovative strategies.

Read the Report

Source: https://www.teladoc.com/

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Tags: Medicare Advantage, Medicare

Update: Medicare is Strong and Built to Last

Posted by www.psmbrokerage.com Admin on Mon, May 06, 2019 @ 03:39 PM

Medicare is Strong and Built to Last

Lindsey Copeland / May 2, 2019 / Medicare Watch

Last week’s Medicare Trustees’ report predicts the Part A Hospital Insurance (HI) trust fund will be partially depleted in 2026. This is the same as last year’s projection, and three years earlier than in 2017—the last report issued before the GOP tax bill took effect.

This is not a coincidence. The 2017 tax bill directly cut funding for the Part A Trust Fund by significantly reducing one of its primary revenue streams—the taxation of Social Security benefits. It also caused some of the projected growth in Part A expenditures. By zeroing out the Affordable Care Act’s individual mandate, the tax bill also increased the number of uninsured—driving up Medicare hospital payments for uncompensated care. Higher spending projections can also be attributed to the tax bill’s repeal of the Independent Payment Advisory Board, which would have helped to control Medicare spending if the growth rate exceeded certain target levels.

Read the 2019 Medicare Trustees Report

Source: https://blog.medicarerights.org/medicare-is-strong-and-built-to-last

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Tags: Medicare

CMS Maintains Important Changes in Draft 2020 Medicare & You Handbook

Posted by www.psmbrokerage.com Admin on Mon, May 06, 2019 @ 03:28 PM

CMS Maintains Important Changes in Draft 2020 Medicare & You Handbook

Julie Carter / May 2, 2019 / Medicare Watch

Last year, the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, released a draft version of the annual “Medicare & You” handbook that contained several glaring inaccuracies. In a significant advocacy success, Medicare Rights and our allies convinced CMS to correct these major errors and release a final 2019 handbook that was greatly improved.

This week, CMS released a draft for the 2020 handbook. We are relieved to see that this draft does not repeat last year’s mistakes.

Read more about our original concerns with the “Medicare & You” handbook in 2019.

Read our thank you letter to CMS as a response to the changes to 2019’s “Medicare & You.”

Source: https://blog.medicarerights.org/cms-maintains-important-changes-in-draft-2020-medicare-you-handbook

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Tags: Medicare, CMS

Humana Sees Population Health Gains for Medicare Advantage Members

Posted by www.psmbrokerage.com Admin on Mon, Apr 29, 2019 @ 04:02 PM


The Bold Goal program has improved population health for Humana Medicare Advantage members since 2015.

By Jessica Kent – HealthPayerIntelligence – April 25, 2019

Medicare Advantage members living in Humana’s seven original Bold Goal communities have seen an improvement in population health, with these individuals experiencing a 2.7 percent reduction in their Unhealthy Days since 2015, according to Humana’s 2019 Bold Goal Progress Report.

Humana’s Bold Goal program aims to improve the health of the communities it serves 20 percent by 2020 and beyond. Since the program began, Humana has used the CDC’s health-related quality of life measurement, known as Healthy Days, to track and trend progress.

Healthy Days takes the whole person into account by measuring self-reported physically and mentally unhealthy days over a 30-day period. The healthy days measurement aligns with the Bold Goal’s aim to address individuals’ physical well-being, along with the social determinants of health, such as food insecurity, loneliness, and social isolation.

San Antonio, the first Bold Goal community, is halfway to its 20 percent healthier goal, with members in this area experiencing a 9.8 reduction in unhealthy days. Humana worked with community organizations, physician practices, and others to screen 500,000 members, employees, and patients for social determinants of health in 2018, leading to the gains in everyday wellness.

The report stated that on average, a Humana Medicare Advantage member who is food insecure may experience 26.6 unhealthy days, while Medicare Advantage members who experience loneliness may see an average of 24.4 unhealthy days.

Humana noted that of those experiencing food insecurity, 66 percent have to choose between food and medical care. Food insecure members are also 50 percent more likely to be diabetic and 60 percent more likely to have congestive heart failure.

Those experiencing loneliness and social isolation are four times more likely to be re-hospitalized within a year of discharge, and 64 percent more likely to develop dementia.

These non-clinical influences can also have detrimental effects on mental health. For those Bold Goal communities that did not see significant improvements in population health, Humana stated that one of the contributing factors was a higher number of mentally unhealthy days versus physically unhealthy days.

“Throughout the country, we are seeing a rise in mental health concerns as well as loneliness and social isolation, especially in our aging adult population. In fact, since the 1980s, the rates of loneliness in adults over the age of 45 have doubled,” said Caraline Coats, Vice President of Bold Goal and Population Health Strategy.

“With the knowledge that mentally unhealthy days and new membership are driving many of our results, several of our Bold Goal communities are looking at ways to address this growing need. We’ve already seen efforts emerge in Tampa Bay, New Orleans and Louisville.”

In Louisville, Kentucky, the Louisville Health Advisory Board’s Behavioral Health Committee trained more than 2200 volunteers in emergency response techniques designed to prevent suicide.

The Tampa Bay Bold Goal Health Collaborative has also been focused on addressing the behavioral health needs of members, partnering with mental health professionals, faith-based organizations, and other stakeholders.

In addition to the social determinants of health, the Bold Goal program aims to improve population health by managing chronic conditions. Nearly 77 percent of Americans aged 65 or older are living with two or more chronic conditions, the report said, making chronic disease management imperative for overall health.

“A large part of Humana’s focus is to help people living with multiple chronic conditions improve their health, which requires an integrated approach,” said Bruce D. Broussard, Humana’s President and CEO.

“The Bold Goal is not just our north star; it’s a quantitative way for us to address the holistic needs of multiple populations, and to measure our progress. This year’s report reflects our track record of success in managing chronic conditions over time. Given current demographic trends, we expect to see continued demand for a support structure that addresses social needs, along with clinical ones.”

In Knoxville, Tennessee, the Knoxville Health Advisory Board has focused on addressing diabetes, which has led to positive trends for low-income Humana Medicare members. These individuals experienced a 2.9 reduction in unhealthy days in 2018.

Going forward, Humana and its Bold Goal communities will continue to address the many factors that influence well-being, with an understanding of the important roles physical, mental, and social elements play in members’ overall health.

“The social barriers and health challenges that our Medicare Advantage members and others face are deeply personal,” said William Shrank, MD, Humana’s Chief Medical Officer.

“This requires us to become their trusted advocate that can partner with them to understand, navigate and address these barriers and challenges. With Healthy Days as our barometer, we are able to track and trend population health, measure outcomes and triage members in unique ways to the resources they need.”

Source: https://healthpayerintelligence.com/news/humana-sees-population-health-gains-for-medicare-advantage-members

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Tags: Humana, Medicare Advantage, Medicare

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