Medicare Advantage and prescription drug plans
The Medicare system is facing unprecedented care and cost challenges. An aging population, medical cost growth and inefficiencies in care continue to stretch our nation’s resources, burden taxpayers and threaten economic well-being. Medicare Advantage helps Medicare overcome its challenges and achieve the goal of high-quality, affordable and accessible healthcare for seniors and people with disabilities.
Medicare Advantage requires reliable funding and a regulatory environment that allows health plans to innovate, improve patient outcomes and lower costs for the entire health system. Strength and stability in the Medicare Advantage program are essential for its millions of beneficiaries, for those who will enroll in the future, and for the Medicare system as a whole.
For more than 20 years, , opens new window has strived to create better health outcomes and simplified experiences for millions of beneficiaries across the U.S. through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms and progressive approaches to care drive Humana Military to be a thought leader in the industry and an essential partner to the government.
Humana Military works with the government to create the right access. Combining resources of federal agencies and Humana Military's integrated healthcare delivery system creates a strong health system that enriches TRICARE members' well-being and supports national security.
Home health and hospice
Most people want to live at home for as long as they possibly can. As people age, many require a higher level of care, yet many struggle to access the services and support they need. Limitations like chronic conditions and declines in functionality threaten independence. However, care management services can greatly improve health outcomes and benefit the support system around individuals receiving care.
By offering unique, personalized care services, Humana At HomeSM and SeniorBridge® work to make it easier, more comfortable and affordable for people to remain at home even when faced with medical and functional challenges. People who receive Humana At Home services live longer and go to the hospital less. Our data shows that, after 6 months, hospital admissions for participants drop 44% compared to admissions before management. And, when professional caregiver assistance is necessary, SeniorBridge can step in with a personalized range of care services that help people live healthier, longer lives at home.
Almost 75 million Americans, including children and those who also receive Medicare, are enrolled in Medicaid. And 55 million of those are covered by Medicaid managed care programs, helping with the long-term care of seniors and those with disabilities.
A recent study1 shows people covered by Medicaid have more access to healthcare services and are able to better manage serious chronic health conditions than those without insurance. Medicaid enrollees with diabetes receive monitoring services like annual cholesterol tests, eye exams and foot exams more often than people without health insurance. Similarly, Medicaid enrollees with mood disorders like bipolar disorder are more likely to receive recommended medications and psychotherapy than uninsured people.
Depending on location, Humana offers Medicaid managed care programs, long-term services and other benefits to those eligible for Medicaid. By working with state programs, Humana Medicaid members are able to access the healthcare services they need.
Social determinants of health
Social determinants of health are the conditions under which people are born, grow, live, work and age that impact overall health and well-being. Humana has a , opens new window to help the communities we serve be 20% healthier by 2020 because we make it easy for people to achieve their best health. And we are focused on improving key social determinants of health and chronic conditions through pilot programs and interventions with community and physician partners.
With the help of the U.S. Centers for Disease Control and Prevention’s tool, “Healthy Days,” we are tracking progress toward our Bold Goal. In addition to Humana Inc.’s focus on social determinants of health, the Humana Foundation has begun investing in and partnering with select nonprofit organizations that are focused on social determinants of health—such as asset and financial security, food security and social connection. The foundation’s investments now have a longer-term focus, recognizing that the change we seek will likely take years to achieve, in partnership with others.
Addressing the opioid epidemic
From 2000 to 2016, more than 600,000 Americans died from drug overdoses, according to the U.S. Centers for Disease Control and Prevention.2 And the crisis has worsened in recent years, driven largely by the abuse of highly addictive prescription opioids like oxycodone and hydrocodone. These drugs, usually prescribed for pain relief, are highly addictive, which often makes quitting them difficult.
Early intervention and treatment can save lives. However, only about 1 in 10 people with substance use disorders receive any type of specialty treatment.3 Coping with and seeking treatment often carries a social stigma that unfortunately keeps many from getting the help that could save their lives. Humana plans with behavioral health benefits may include coverage for substance use disorders treatment that can focus on intensive and early intervention, personalized care that focuses on the whole person, and an effort to remove the stigma associated with having a substance use disorder.
Humana Pharmacy® is also working to address safety concerns regarding opioid prescriptions. Several point-of-sale drug safety measures have been implemented to bring greater awareness, especially in situations where patients have multiple health conditions and more than one prescribing doctor.
Health insurance tax
The Affordable Care Act (ACA) authorized a health insurance tax starting in 2014 that was projected to generate $142 billion over 10 years, according to the Joint Committee on Taxation.4 Unfortunately, the tax ultimately is a de facto tax on seniors and disabled people, small business owners, and self-employed individuals—as much of the tax impacts coverage costs for individuals with Medicare Advantage plans, managed Medicaid health plans, or fully insured commercial plans, per Congressional Budget Office findings.5
In early 2018, Congress approved a 1-year suspension of the tax for the 2019 calendar year. Now, Congress should permanently repeal the health insurance tax to prevent the potential for greater health access problems, job losses and increases in health costs beyond current trends. Unless Congress acts, the health insurance tax will return in 2020.
The tax is contrary to the ACA’s goal of increasing health insurance access and making coverage more affordable to individuals and families.