Overview

We know living and aging well is important. We designed our Healthy Behaviors Program to:

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

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

  1. Health risk assessment (HRA) – Offers qualifying members an incentive to complete the assessment.
  2. Baby well visit (BWV) – Encourages the frequency of child well visits to a primary care physician during the first 18 months of a baby’s life
  3. Moms First prenatal and postpartum – Rewards qualifying members 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
  4. Pediatric well visit (PWV) – Encourages a yearly pediatric well visit for members between the ages of 2 and 21
  5. Humana Family Fit – Rewards obese and overweight members who enroll in and complete a 6-month weight management program AND who complete a biometric screening with their PCP at the end of the 6-month period
  6. Smoking cessation – Offers members who smoke access to a six-month program that includes counseling and a reward to help them quit smoking
  7. Substance abuse – Offers members who drink and/or use drugs access to a six-month program that includes counseling, medication therapy, and a reward to help them live a drug- and/or alcohol-free life

Performance*

Program Enrollment Completion Completion Rate** Health Risk Assessment 6,393 6,393 76% Baby Well Visit 7,221 2,431 28% Moms First Prenatal and Postpartum 4,936 541 12% Pediatric Well Visit 17,385 4,622 33% Humana Family Fit (Medically Directed Weight Loss Program) 96 31 26% Smoking cessation 119 9 6% Substance abuse 83 13 10%

*The above information reflects program enrollment and completion between July 1, 2019 and June 30, 2020 (the Agency for Health Care Administration’s fiscal year). The above metrics show increases compared to the yearly program review for the period ending June 30, 2019, as this year’s report covers a full 12-month period. Note: All Healthy Behaviors programs except for the completion of a HRA, can take more than 6 months to complete. The COVID-19 pandemic negatively affected wellness and preventive rates during the first and second quarters of calendar year 2020 as routine scheduled office visits were postponed and/or delayed. As of this report, we cannot yet determine the long-term complications related to COVID-19.

** Completion percentages are calculated from the enrollee’s original program enrollment date, which could occur in a prior reporting period.

Clinical success measures

The below clinical success measures reflect program and/or activity completion dates of between July 1, 2019 and June 30, 2020 (and rewards paid through July 31, 2020). We compared data for members who enrolled in and/or completed one or more programs with Humana Florida Medicaid members who did not enroll into a Healthy Behaviors Program.

Health Risk Assessment (HRA)

  • The contract requires us to complete an HRA on 70% of pregnant enrollee’s, and 50% of enrollee’s with diabetes, asthma, and serious mental illness.
    • Of the members we were able to contact, we completed a total of 6,393 HRA’s totaling a weighted average of 76%.

Baby/Pediatric Well Visit

  • Increased primary care physician (PCP) engagement improved early detection of illness or developmental delays, and improved adherence to treatment plans
    • Baby and pediatric members completing the programs had approximately 65% more well visits than those who did not complete the program and lower emergency room (ER) utilization for emergent and non-emergent visits

Moms First Prenatal and Postpartum

  • Increased compliance with prenatal and postpartum appointments
    • Members engaged in the Moms First Prenatal and Postpartum program, on average, completed more than twice the number of well visits as members not engaged in the Moms First Prenatal and Postpartum program
  • Increased early identification of preterm and postpartum risk and complications and reduced ER admissions, preterm delivery, and adverse outcomes
    • Members engaged in the Moms First Prenatal and Postpartum program had fewer emergent and non-emergent visits compared to members not engaged in the Moms First Prenatal and Postpartum program
    • Members engaged in the Moms First Prenatal and Postpartum program had a 9.6 percent pre-term delivery rate, and members not engaged in the Moms First Prenatal and Postpartum program had a 12 percent pre-term delivery rate

Smoking Cessation/Substance Abuse/Family Fit

Because smoking, substance abuse, and excessive weight 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.

Next steps

To promote member engagement AND improve health outcomes, we have:

  • Increased efforts to promote (such as through a call campaign or member education) and enroll members into the Healthy Behaviors Program
  • Invested in technology to help improve personalized engagement and self-service
  • Proposed revisions to current program offerings to increase our members’ choice of rewards

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

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