Overview

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 must have their Medicaid member ID

Our Healthy Behaviors Program includes 7 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 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. Moms First 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 up who drink and/or use drugs a choice of completing 6 telephonic coaching sessions within 3 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.

Performance1

Program Enrollment Completion Completion Rate2 Health Risk Assessment (HRA) 3,750 3,750 100% Well-Child Visit Program3 (Baby Well Visit & Pediatric Well Visit) 38,295 8,577 22% Adult Well-Visit Program3 99 99 100% Moms First Prenatal and Postpartum Program 3,638 557 15% Medically Directed Weight Management Program 167 30 18% Medically Approved Smoking Cessation Program 81 7 9% Medically Approved Substance Abuse Program 70 12 17%
1The above information reflects program enrollment and completion between July 1, 2020, and June 30, 2021 (the Agency for Health Care Administration’s fiscal year). Note: All Healthy Behaviors programs, except for the completion of an HRA, can take more than 6 months to complete.

2Completion percentages are calculated from the enrollee’s original program enrollment date, which could occur in a prior reporting period.

3In April 2021, Humana Healthy Horizons™ in Florida launched its Healthy Behaviors program via Go365® for members 18 years and older. We combined the Baby Well-Visit and Pediatric programs for members under 18 years of age, which is called Well-Child Visit program—this is the reason for the high enrollment and completion rates. In addition, we created the Adult Well-Visit program, which is new, hence the reason for a modest enrollment and completion rates.

Clinical Success Measures

The below clinical success measures reflect program and/or activity completion dates between July 1, 2020 and June 30, 2021 (and rewards paid through July 31, 2021). 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)

  • 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 3,750 HRAs on members we were able to contact.
    • 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 Moms First 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.
    • Baby and pediatric members completing the programs had 51% and 74%, respectively, more well visits than those who did not complete the program.

Adult Well-Visit Program

  • Because this program is new, we are unable to measure the effectiveness of this Program.

Moms First Prenatal and Postpartum Activities*

  • Involvement in this program increased early identification of preterm and postpartum risk and complications.
    • Members engaged in the Moms First Prenatal and Postpartum program had approximately 163% more well visits when compared to members not engaged in the Moms First Prenatal and Postpartum program.
    • Members engaged in the Moms First Prenatal and Postpartum program had an 11.9% preterm delivery rate, and members not engaged in the Moms First Prenatal and Postpartum program had an 11.8% preterm delivery rate.

*Members who are enrolled in the Moms First program have higher comorbidities, such as hypertension and behavioral health issues, than those who are not enrolled. In addition, enrollment in the Moms First program increases members’ timeliness of prenatal and postpartum visits.

Tobacco Cessation/Substance Abuse/Weight Management programs

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.

Next steps

To 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.

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