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HIMSS15 Keynote: Value, interoperability are keys to success

Humana CEO calls on healthcare industry to transform itself
By Richard Pizzi
01:21 PM
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U.S. healthcare must transition from a supply-based to a demand-based system, with patient choice at the center, said Bruce Broussard, Humana’s president and CEO, at the HIMSS15 Annual Conference & Exhibition on Tuesday.

Keynoting the second full day, Broussard emphasized themes becoming increasingly common in the healthcare industry: that volume-based care is not long for the world, while a value-based reimbursement system is the unavoidable future.

“Eighty percent of healthcare costs are related to chronic conditions,” he said. “But our current system was not designed for chronic care management. It was built for episodic care. Both consumers and providers are victims of the system.”

Broussard acknowledged that health insurers have been “part of the problem” in perpetuating the currently misaligned system, but he vowed that Humana, at least, would help drive transformation.

“Insurance companies must make the healthcare system simpler for consumers,” he said. “We have to change from an underwriting business model to a health improvement model.”

Industry transformation can be painful, Broussard noted, but he said the difficulties in moving away from volume-based care would ultimately yield improved health outcomes and cost control. He praised the U.S. Department of Health and Human Services for its stated intention to tie 30 percent of fee-for-service Medicare payments to quality or value through alternative payment models, such as accountable care organizations or bundled payment arrangements by the end of 2016.

“Value-based reimbursement and interoperability are the keys to change,” he said. “The lack of both means we remain in a siloed healthcare system.”

Broussard’s message to the IT audience was blunt – U.S. healthcare doesn’t need new technologies for transformation, it needs new perspectives.

“The problem is in this room, with all of us,” he said. “We have to be bold leaders in changing healthcare, because the consumer is looking for us to change. Interoperability is a great place to start. Information should be a shared asset, not a proprietary asset.”

Some U.S. employers have seen the light, Broussard noted, and have begun to look at their employees’ health holistically. Forward-thinking companies are including wellness benefits in their health plans, for instance, and are paying for employee health risk assessments.

Humana itself is changing, Broussard said, revealing that compensation for his senior leadership team is based not only on earnings per share – common for a public company – but on the health engagement scores of members.

“We want to improve the health outcomes of our communities 20 percent by 2020,” he said. “We’re measuring this by a concept called ‘healthy days.’ We ask members four questions about their physical and behavioral activities, based on an approach used by the CDC. There is a high correlation between certain answers to those questions and healthy outcomes.”

Broussard said Humana’s experience suggested a combined “high-tech, high-touch” approach to care that will have the most impact on outcomes.

“Improving the consumer experience with healthcare depends on personalization, not just data-driven personalization, but face-to-face conversation to drive better decision-making,” he said.