Healthy Behaviors Yearly Program Review

Go365 for Humana Healthy Horizons^® is a wellness program that offers members the opportunity to earn rewards for taking healthy actions. We know living and aging well is important, so we designed our Healthy Behaviors program to:

• Encourage and reward healthy behaviors
• Help members take steps toward being and staying healthy
• Help members reach their health and wellness goals

It is easy to participate in healthy activities and earn rewards through our Go365 for Humana Healthy Horizons wellness program. To earn rewards, members must:

• Download the Go365 for Humana Healthy Horizons app from iTunes^®/Apple Store^® or Google Play^® on a mobile device
• Create an account to access and engage in the program
  • Members who are 18 and older can register to create a Go365 account. Members must have their Medicaid Member ID.
  • Members under the age of 18 must have a parent or guardian register on their behalf to participate and engage with the program. The person completing the registration process on behalf of a minor must have the minor’s Medicaid Member ID.

Members who have a MyHumana account, can use the same login information to access Go365 for Humana Healthy Horizons, after they download the app.

Our Healthy Behaviors Program includes 8 types of activities that eligible members can complete to earn a reward:

1. Health risk assessment (HRA): Offers all members an incentive to complete the HRA.
2. Well-Child Visit: Encourages members under 18 years old to have a wellness visit with their primary care physician (PCP). 
3. Adult well visit: Encourages new members 18 years and older to have a wellness visit with their PCP within 90 days of enrollment in the plan.
4. HumanaBeginnings™ prenatal and postpartum activities: Rewards members 13 and up who take advantage of prenatal and postpartum education and care management to help decrease the risk of pregnancy complications (such as preterm delivery) associated with high-risk pregnancies.
5. Weight management: Rewards members 12 years and older who enroll in the program and complete 6 telephonic coaching sessions with a health coach. Members must complete a well-being visit with their PCP prior to enrolling in the program and must visit their PCP at the end of the sixth coaching session for a final well-being checkup and to submit the final PCP form.
6. Tobacco Cessation: Offers members 12 years and older who smoke or vape 8 telephonic coaching sessions and a reward to help them quit smoking or vaping. Complimentary Nicotine Replacement Therapy (NRT), like patches, gum, and lozenges, is only available to eligible members 18 years and older.
7. Substance Abuse: Offers members 18 and older who drink and/or use drugs a choice of completing 6 telephonic coaching sessions within 6 months or actively participating in an outpatient program for 28–30 days to help them live a drug- and/or alcohol-free life. Members have a choice to participate in 1 or both programs.
8. COVID-19 Vaccine Program: Offer members 6 months and older a reward when they get the complete COVID-19 vaccine and upload a picture/file of their completed COVID-19 vaccine card on Go365

The below clinical success measures reflect program and/or activity completion dates between July 1, 2021, and June 30, 2022 (and rewards paid through July 31, 2022). We compared data for members who enrolled in and/or completed one or more programs with our members who did not enroll into a Healthy Behaviors Program.

Health Risk Assessment (HRA)

• Overall, we completed 57,482 HRAs for members of all ages
  • The contract requires us to complete an HRA on 70% of pregnant enrollees and 50% of enrollees with diabetes, asthma, and serious mental illness. We completed 7,971 HRAs on members we were able to contact with these four health conditions.
    • Eligible members who were identified with asthma and/or diabetes were referred to Humana’s Disease Management programs with the goal of improving health outcomes by assessing their needs and implementing interventions to assist members with complex medical needs.
    • Eligible members who were identified as pregnant were referred to our HumanaBeginnings program where they engage with case managers to help improve birth outcomes and encourage prenatal and postpartum visits.

Well-Child Visit

• Increased PCP engagement improved early detection of illness or developmental delays and improved adherence to treatment plans.
  • Members under 18 years old completing the program had 136% more well visits than those who did not complete the program

Adult Well-Visit Program

• Increased education on annual wellness visits helped to prevent an illness or catch health problems early so they can be treated.
  • 67,937 members 18 years and older had a wellness visit within Fiscal Year 2021 – 2022 of which 5,653 members had a wellness visit within 90 days of joining the program

HumanaBeginnings Prenatal and Postpartum Activities*

• Involvement in this program increased early identification of preterm and postpartum risk and complications.
  • Members engaged in the HumanaBeginnings Prenatal and Postpartum program had approximately 281% more well visits when compared to members not engaged in the HumanaBeginnings Prenatal and Postpartum program which is a 72% increase from prior fiscal year (163%)
  • Members engaged in the HumanaBeginnings Prenatal and Postpartum program had an 11.6% preterm delivery rate, a 3% decrease from prior fiscal year (11.9%)

*Members who are enrolled in the HumanaBeginnings program have higher comorbidities, such as hypertension and behavioral health issues, than those who are not enrolled. In addition, enrollment in the HumanaBeginnings program increases members’ timeliness of prenatal and postpartum visits, helps to close gaps with Social Determinants of Health, assesses Behavioral Health needs and provides access to Behavioral Health providers.

COVID-19 Vaccine Program

• Getting the COVID-19 vaccine helps to prevent illness, helps to prevent spreading of the disease, and even help to prevent death.
  • 13.6% of our total membership are fully vaccinated within Fiscal Year 2021 – 2022 of which 11,802 enrolled and completed the program
  • Emergency Room (ER): When looking at fully vaccinated members that enrolled and completed the program, for every thousand members, there were 234.1 emergent ER visit rate when compared to the general population who were not vaccinated within Fiscal Year 2021 – 2022 had a 371.2 emergent ER visit rate
  • Non-Emergency: When looking at fully vaccinated members that enrolled and completed the program, for every thousand members, there were 147.2 non-emergent ER visit rate when compared to the general population who were not vaccinated within Fiscal Year 2021 – 2022 had a 234.7 non-emergent ER visit rate

Tobacco Cessation/Weight Management programs/Substance Use

Because smoking, substance abuse, and weight management can cause adverse health outcomes and complications years or even decades after the successful completion of a program, measuring program efficacy is difficult during a 12-month period. To help minimize and quantify, to the best of our ability, the detrimental effects of these conditions, we increased health outcome education, awareness, and consequences of these conditions for members as they enroll into either program and as they complete the program and as they complete the program. We’ve seen remarkable increase in completion rate on all three programs when compared to prior fiscal year.

To continuously promote member engagement and improve health outcomes, we have:

• Increased efforts to promote and enroll members into the Healthy Behaviors program via year-round, robust, omnichannel tactics, including a welcome kit, email, text, social media, webpage, outbound calls, educational flyers, and videos.

We also continue to collaborate with the Agency for Health Care Administration, vendors, and other community engagement programs to help improve the health and well-being of our members.