Medicaid health and wellness

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Humana Florida Medicaid wants to help you reach your best health. We’re more than just a healthcare company—we care about your whole health journey.

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Wellness programs for members

Whether you are trying to improve your quality of life, have a healthy pregnancy or find mental health resources, there is a program to fit your unique needs.

Find health and wellness programs to help you on your path to health and well-being.

For more details on each of these programs, view your member handbook.

Quality enhancement programs

There are many programs to help you improve your quality of life. Your Humana medical plan can guide you to the programs available in your area. To learn more about these services, call your primary care doctor or the Humana medical plan Customer Care department at 1-800-477-6931 (TTY: 711).

  • SafeLink mobile phone: Stay in touch with family, friends and doctors with a free smartphone from Humana and SafeLink Wireless. Download SafeLink mobile phone flyer 719 KB, PDF opens new window

  • Domestic violence program: Your doctor should check for signs of domestic violence at your yearly visit. You can also get educational information from your doctor.
  • Pregnancy prevention program: We can refer you to community pregnancy prevention programs that are open to you. You can use them no matter what your age, gender, pregnancy status, or parental consent.
  • Prenatal/postpartum program: We have a before - and after - pregnancy program. You will have a case manager who will help you through your pregnancy and give you learning materials. The program also provides incentives, or ways to keep you on track, for healthy behaviors. When you have your baby, you will get more information about family planning from your case manager and your PCP.
  • Children’s program: Humana Medical Plan can refer you to children’s programs in your local area that help prevent health problems and give early healthcare services to families with children aged 0 – 5 years old. Humana Medical Plan also teams with your PCP to help you keep your children healthy.
  • Fall Risk Prevention. We have a Fall Risk Prevention process that involves screening, assessment, and care planning. A case manager will handle this process with you and provide education on fall prevention and appropriate service referrals.
  • New Medical Treatment. Sometimes new treatments work very well and sometimes they do not. Some can even have bad side effects. We track new medical research. This is how it decides new benefits for your health plan. If you think a new medical technology or treatment might help you, call your PCP. Your PCP will work with us to see if it can help you and will be covered by us.
  • Complex Case Management. Medicaid members may be eligible to get Complex Case Management services if they have experienced multiple hospitalizations or have complex medical needs that require frequent and ongoing assistance. Complex Case Management is provided to Medicaid members by Humana nurses specially trained in case management. A team of Physicians, Social Workers and Community Service Partners are on hand to help make sure your needs are met and all efforts are made to improve and optimize your overall health and well-being. The case management program is optional.
  • Behavioral health services: For behavioral health services, please call the behavioral healthcare provider in your area. Behavioral health services are available to you without a referral from your PCP. The behavioral healthcare provider in your area can give you a list of common problems with behavior and they can talk to you about how to recognize the problems.

You can find a behavioral health provider based on where you live. If this is an emergency, go to the nearest hospital or emergency room (ER).

Call our central Behavioral Health line at 1-888-778-4651 (TTY: 711)

Healthy behavior programs

A healthy lifestyle is important to start early and maintain throughout your life. These programs help encourage healthy behaviors and will help you reach goals and earn rewards, like gift cards. Call the number listed for each program to learn more.

  • Baby well visit program: This program is for babies 18 months and younger. They must be members since birth. Call Humana at 1-800-611-1467 (TTY: 711) to learn more and sign up.
  • Pediatric well visit program: This program is for children aged 2–21. Call Humana at 1-800-611-1467 (TTY: 711) to learn more and sign up. You can only sign up once per year.
  • Mom’s First prenatal/postpartum program: If you are pregnant, call Humana at 1-800-393-8858 (TTY: 711) to learn more and sign up.
  • Smoking cessation program: If you are 18 years or older, call Beacon Health Options at 1-844-265-7590 (TTY: 711) to learn more and sign up.
  • Substance abuse program: If you are 18 years or older, call Beacon Health Options at 1-844-265-7590 (TTY: 711) to learn more and sign up. Find opioid addiction resources (SAMHSA website), opens new window
  • Humana family fit program: If you are 18 years or older, call Humana at 1-855-330-8053 (TTY: 711) to learn more and sign up.

Medicaid Healthy Behaviors Yearly Program Review

Overview

A healthy lifestyle is important to start early and maintain throughout your life. These programs are designed to help encourage healthy behaviors, help you reach your goals, and earn rewards such as gift cards. The information below represents our yearly evaluation of this program.

  1. Health Risk Assessment (HRA) - Offers qualifying members an incentive to complete a Health Risk Assessment.
  2. Baby Well Visit (BWV) - Encourages the frequency of child well visits to the primary care physician during critical periods in the baby’s growth and development.
  3. Moms First Prenatal and Postpartum - Incentivizes enrollees for prenatal and postpartum education and care management to help decrease the risk of pregnancy complications including preterm delivery associated with high-risk pregnancies.
  4. Pediatric Well Visit (PWV) - Incentivizes enrollees to complete their annual well-child visit.
  5. Humana Family Fit - Incentivizes obese and overweight members to join a 6-month weight management intervention.
  6. Smoking Cessation - Encourages members to quit smoking through both counseling and medication therapy.
  7. Substance Abuse - Encourages members to maintain and live a drug-free and/or alcohol-free lifestyle.

Performance

The program enrollment and completion counts are from July 2018 through June of 2019.

Program Enrollment Completion Health Risk Assessment 8,669 8,669 Baby Well Visit 5,272 3,021 Pediatric Well Visit 10,792 8,985 Mom’s First Prenatal and Postpartum 4,971 932 Humana Family Fit 16 2 Smoking Cessation 72 4 Substance Abuse 58 2
*Note the Health Risk Assessment counts began in December with the roll out of our new contract.

Clinical Success Measures

Baby/Child Well Visit

  • Increased primary care physician engagement/encounters, improved early detection of illness or developmental delays, and improved adherence to treatment (as applicable) leading to lowered ER and IP utilization (risk adjusted).
  • Increased immunization rates.

Moms First

  • Increased enrollment/engagement and decreased incidents of preterm deliveries.
    • Reduced preterm deliveries
  • Increased compliance with prenatal and postpartum appointments.
    • Early identification and reduced preterm and post-partum risk and complications leading to ER, admissions, preterm delivery, and adverse outcomes.

Substance Abuse/Smoking Cessation

  • Reduced both medical and behavioral health costs by reducing admissions to ER and acute levels of care.
  • Increased utilization of community resources and community providers to build a network of support to reduce risk of relapse.
  • Increased use of healthy coping skills when facing psychosocial stressors resulting in improved member life styles and overall well being.

Family Fit

  • Increased enrollment and member engagement around activities to reduce weight, increase physical activity, and improve nutrition. The goal is to promote a healthy lifestyle and reduce adverse outcomes and disease progression related to obesity.

Next Steps

Here at Humana, we have increased the call campaigns for the Healthy Behavior programs to promote member engagement.

The program has devoted new resources as Humana’s Medicaid focus has become a strategic focus. More attention and emphasis has been placed on all Healthy Behaviors programs to promote engagement. New partnerships with clinical personnel will help drive member and program engagement.

We are excited to partner with AHCA, vendors, and other community engagement activities to better improve overall wellness to our members’ lives.

Mental health services

Your mental health is just as important to us as your physical health. Call a mental healthcare professional in your area to get mental healthcare services.

Mental healthcare professionals can also talk to you about how to recognize the signs of a mental health condition.

Treatments for mental health conditions include access to the following services:

  • Home visits by a clinical social worker, 48 visits per year
  • Art therapy
  • Equine therapy, 10 sessions per year
  • Pet therapy
  • Assessment and screening services
  • Intensive outpatient treatment
  • Day services/day treatment
  • Medical services including:
    • Verbal interaction
    • Medication management
    • Drug screenings
  • Computerized cognitive behavioral analysis
  • Community based wrap-around services (up to 10 hours per week for up to 4 months)
  • Medication assisted treatment
  • Psychosocial rehabilitation
  • Substance abuse treatment or detox
  • Respite Care (300 hours of in home and up to 15 days out-of-home)
  • Individual or family therapy
  • Group therapy
  • Therapeutic behavioral on-site services
  • Targeted case management

Family planning services

With Humana Florida Medicaid, you can get family planning services from your current doctor. This allows your doctor to take care of all your healthcare needs. You also can choose to get care from any doctor that has family planning services. You do not need to get approval ahead of time. For more information, call the Humana medical plan Customer Care department at 1-800-477-6931 (TTY: 711).

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