How Healthcare Payors Are Leveraging Voice Apps And Chat Bots

Innovative healthcare payors are exploring new opportunities for using conversational experiences to enhance member engagement and improve care management. 

Readers of this blog may be interested in finding out about a webinar being conducted by Orbita that will share lessons learned in developing a conversational virtual health assistant.

The webinar will take place on Wednesday, August 29th from 1PM-2PM Eastern and will feature Jessie Gatto, Senior Innovation Strategist & Information Designer at Humana Healthcare Trend and Innovation.

Humana’s innovation team recently completed a pilot that yielded highly valuable insights for developing the capabilities and know-how needed to roll out a successful voice initiative.

Find out more here.

Humana Partners With Walgreens to Get “Close to Home”

From AIS Health Daily

Today’s feature story in the AIS Daily reports that Humana Inc. is testing a new retail-based primary care approach with Walgreens. Through a joint effort, Humana subsidiary Partners in Primary Care (PiPC) will furnish primary care and other services in two retail spaces in the Kansas City, Mo., area beginning this fall.

The story says that “The “neighborhood” approach will feature “health navigation” through which Humana representatives will be available in the stores to assist seniors in accessing numerous health-related services.”

This harks back to earlier times when Humana also owned hospitals and placed nurses in dedicated spaces within them to help seniors navigate health services, insurance, and Medicare claims filing. It was called the Humana Seniors Association and proved to be a successful integration that fostered customer loyalty.

AIS Subscribers may read the in-depth article online. Learn more about subscribing to AIS Health’s publications.


Humana Appoints Christopher Kay as Chief Innovation Officer

LOUISVILLE, Ky.–()–Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today that it has appointed Christopher Kay as Senior Vice President and Chief Innovation Officer, effective March 17. Kay will report to President and Chief Executive Officer Bruce Broussard and serve on the company’s Management Team.

In his new role, Kay will lead the company’s innovation strategy. Among other priorities, he will focus on innovations in personalized health designed to simplify the health care experience, leading to better health outcomes. Continue reading

Humana Teams Up with CoverMyMeds to Improve Prior Authorization Process for Members

LOUISVILLE, Ky.–()–Humana Inc. (NYSE: HUM) and CoverMyMeds, a leading health care innovation company, have recently teamed up to implement an electronic prior authorization model that allows providers to streamline prescription authorization requests, giving patients expedited access to the medications they need.

“Depending on the prescription, some medications require prior authorization before coverage which, as of now, is a time-consuming process for all parties”

Under the new agreement, physicians can submit drug prior authorizations directly to Humana via an online portal. The requests begin processing immediately and providers receive a notification of the status of the member’s prior authorization, often before the member even leaves the doctor’s office. Continue reading

Humana Launches Blue Button® Resource that Provides Members Access to Their Medical Information Digitally

LOUISVILLE, Ky.–(BUSINESS WIRE)–Humana Inc. (NYSE: HUM), one of the country’s leading health and well-being companies, is taking another step to simplify the ability of members to take charge of their health by providing access to their medical and financial information in digital form in alignment with the Blue Button initiative.

Blue Button, accessible to Humana health plan members that use, encourages these members to participate in and manage their health and health care. The technology equips them with tools to understand and track their health benefits in an easy, streamlined way. Blue Button furnishes members with detailed health and claims records, which they can bring to physician visits to discuss their health and treatment options. Continue reading

Humana and CVS Announce Strategic Retail Partnership

LOUISVILLE, Ky. & WOONSOCKET, R.I.–(BUSINESS WIRE)–Humana Inc. and CVS/pharmacy have announced a strategic retail partnership designed to educate individuals and their families about their health care coverage options under the Affordable Care Act (ACA).

Humana representatives will be present at CVS/pharmacy’s Project Health events starting this month. Humana will also be holding in-store events at CVS/pharmacy locations to educate individuals and their families about health care coverage options under the ACA.

Humana and CVS/pharmacy will also provide educational brochures and other materials that will be available to individuals and their families.

See the full story at

Humana Seeking New Tools & Technologies To Move Beyond “sick care” Business Model

How does a corporate behemoth heavily invested in the transaction-based health care system of today make the shift to engaging with its 20 million+ customers about their health in new and deeper ways? Humana’s new CEO Bruce Broussard sees technology as key to successfully meeting this challenge.

See the full story at


Humana Delivers on Well-being Commitment with Launch of HumanaVitality Wellness and Loyalty Program

LOUISVILLE, Ky.–(BUSINESS WIRE)–This week, Humana Inc. (NYSE: HUM) health plan members start earning rewards for their efforts to live healthier lives through the launch of HumanaVitality – a wellness and loyalty program that features a wide range of well-being tools and rewards from leading reward-partners. A key element of the program is a sophisticated health-behavior-change model supported by an actuarially sound incentive program.

“Humana is focused on innovation and providing our members a program that will help them succeed at pursuing better health and achieving lifelong well-being”

HumanaVitality is now included with Humana commercial members’ medical plans when they begin a new plan year with Humana. As Humana members enroll in the program, they’ll get the information they need to get started, improve their health and earn points to redeem for rewards.

“Humana is focused on innovation and providing our members a program that will help them succeed at pursuing better health and achieving lifelong well-being,” said Michael B. McCallister, Humana’s chairman of the board and chief executive officer. “With the launch of HumanaVitality we are excited to have our members experience this comprehensive, proven wellness solution. Humana members will be more motivated and rewarded to make positive behavior changes such as exercising more, eating better, quitting smoking, or getting a preventive screening, regardless of their current level of fitness.”

The process of earning rewards is simple. First, members will go through a health assessment to determine their “Vitality Age” – which can be different from their biological age. Vitality Age provides each member with a scientifically calculated representation of their risk-adjusted, or “true” age, and allows members to easily understand how their current behaviors are impacting their health.

Next, members are presented with a set of “personal pathways” or recommended goals to help improve their health based on their individual health needs. Members self-select which goals to pursue. HumanaVitality provides incentives for more than 30 activities, broken into four categories:

  • Fitness (i.e. daily exercise)
  • Healthy Living (i.e. participating in a stop-smoking program)
  • Prevention (i.e. biometric screening)
  • Education (i.e. getting CPR certification)

Children can also earn Vitality Points for their family by receiving immunizations, flu shots and participating in team sports.

“With up to 70 percent of the nation’s health care budget consumed by behavioral issues including tobacco use, poor diet, inactivity and stress, we are encouraged that we can offer members a path and tools for change with HumanaVitality,” said Sean Slovenski, HumanaVitality’s chief operating officer. “This program works and we’re eager to help Humana members across the country get started on the road to better health and better lives.”

HumanaVitality enrollees who engage in healthy activities will earn points, allowing members to progress from their initial Blue Level status to Bronze, Silver, Gold and Platinum. Each level offers increasing rewards such as electronics, hotel stays or discounts with participating merchants that can be redeemed at the HumanaVitality Mall.

HumanaVitality is a joint venture between Humana and the Vitality program parent company, Discovery Holdings Ltd. (JSE: DSY), which is based in South Africa. Discovery Vitality, an international brand, is a science-based wellness solution that encourages healthy behaviors that reduce long-term health care costs by rewarding members for improving their health. Established more than 10 years ago, Vitality has built a comprehensive integrated approach to lifestyle improvement that works. In fact, a 2010 study from the American Journal of Health Promotion shows that individuals who regularly participated in the Vitality program experienced shorter and fewer hospital stays than those who didn’t participate or weren’t very engaged in the program.

HumanaVitality is not available to Humana Medicare members. It is also not available in some states or territories and may not be available with some plans.

About HumanaVitality

HumanaVitalitySM, headquartered in Chicago, is a joint venture between Humana and Discovery Holdings, Ltd. Humana partnered with Discovery because of its 13 years of worldwide reputable experience using behavioral, clinical and actuarial science to motivate individuals to make healthier choices. By integrating rewards with health, HumanaVitality provides the tools and support necessary to help Humana members live healthier lives and furthers Humana’s Dream to Help People Achieve Lifelong Well-BeingSM.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.


Norton Healthcare and Humana Launch Accountable Care Organization in Louisville, Ky.

LOUISVILLE, Ky.–(BUSINESS WIRE)– Humana Inc. (NYSE:HUMNews) and Norton Healthcare, both based in Louisville, Ky., have been working together to launch the region’s first commercial Accountable Care Organization (ACO). The Norton-Humana partnership began in early 2010. An ACO model establishes incentives for health systems to increase quality and efficiency, better coordinate patient care, eliminate waste, and reduce the overuse and misuse of care.

The Engelberg Center for Health Care Reform at the Brookings Institution and The Dartmouth Institute for Health Policy and Clinical Practice selected Humana and Norton Healthcare to partner in one of only five national pilot sites, the only one in Kentucky, to implement the ACO model through the Brookings-Dartmouth ACO Pilot Project. The other pilot sites include Carilion Clinic, Roanoke, Va.; Tucson Medical Center, Tucson, Ariz.; HealthCare Partners Medical Group, Torrance, Calif.; and Monarch HealthCare, Irvine, Calif. Humana has worked with Brookings-Dartmouth since 2008 on exploring the ACO concept and other innovative payment models.

“Norton Healthcare’s work in developing an integrated health care delivery system and Humana’s commitment to continuous improvement in quality provide a strong foundation from which to pilot the payment reforms central to ACOs,” said Dr. Elliott Fisher, director of the Center for Population Health at The Dartmouth Institute for Health Policy and Clinical Practice.

“Norton Healthcare is proud to be a participant in the Brookings-Dartmouth ACO Pilot Project and we feel this is a tremendous opportunity to participate in an alternative model for health reform,” said Dr. Steve Hester, Norton Healthcare senior vice president and chief medical officer. “Considering our health care system’s industry-leading commitment to measuring and openly reporting on the quality of our care; our progress toward a system-wide integrated electronic medical record; and our large base of employed primary- and specialty-care physicians, Norton Healthcare was the logical choice in our region to be an ACO pilot participant.”

Humana is a leading health-benefits provider in its corporate hometown of Louisville, Ky., with a broad network of hospitals and health systems in Kentucky and Southern Indiana. Humana has had extensive experience in partnerships aimed at improving health care delivery and reimbursement models for many years. Norton Healthcare is the Louisville area’s leading health care system, caring for nearly one of every two patients at more than 100 locations throughout Greater Louisville and Southern Indiana.

“Humana is committed to innovative local and national models that improve clinical outcomes, reduce costs and improve efficiencies,” said Bruce Perkins, senior vice president of Humana’s healthcare delivery systems and clinical processes organization. “Humana plans to continue to develop more ACO models by partnering with providers in multiple regions. Our focus in exploring additional ACO relationships is to help drive innovation in the marketplace.”

Rewarding effective care, not quantity

The ACO model has gained national recognition as a meaningful way to create new financial incentives in our current health care system by holding health care providers accountable for the overall effectiveness, efficiency and cost of the care they provide. In contrast, the current fee-for-service payment system rewards volume and intensity rather than efficiency and effectiveness of care, often penalizing those systems that attempt to improve care. ACOs have been specifically addressed in the recent federal health care reform legislation through a new Medicare shared-savings program. And ACOs have been applauded for their intent to support patient engagement and the promotion of evidence-based medicine.

“Accountable Care Organizations are a model for delivery reform that can be part of a solution to help transform our nation’s health care system from one that promotes excessive costs to one that explicitly supports providers when they take steps to achieve high-quality care at lower costs,” said Dr. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution. “We look forward to working with Norton Healthcare and Humana to test this promising new model.”

The Brookings-Dartmouth team, led by Drs. Fisher and McClellan, is working closely with Humana and Norton Healthcare to offer technical and strategic support in the implementation of the ACO model. Each ACO site defines the patient population it serves and establishes a spending target that reflects the predicted costs for their patients. The goals of ACOs are to improve efficiency and effectiveness of care and slow spending growth. ACO providers who can demonstrate that they meet these goals will receive in return a portion of the savings achieved.

“The ACO model really gets at bending the cost curve, which is so vital to achieving a sustainable system,” said Dr. Fisher. “Only health systems that can slow their spending growth, compared to previous years, will have the opportunity to receive shared savings.”

Although the Norton-Humana ACO is still in its early stages of implementation, the pilot has identified several initial areas of emphasis, such as improvements in the use of preventive screenings and tests (such as mammograms) and vaccinations, better coordination in the management of chronic illnesses (such as heart failure), more effective treatment of common problems (such as back pain), appropriate utilization of generic drugs to lower costs, and improved access to the appropriate level of care (such as primary care rather than emergency department treatment).

Going Forward

As the Louisville area’s largest hospital and health care system, Norton Healthcare is committed to providing quality health care. Norton has a sophisticated infrastructure for measurement of quality and data management in place. Looking ahead, Norton plans to move from process metrics to outcomes metrics, further develop innovative delivery models of care, and assume broader responsibility for health care delivery.

“Humana recognizes the need for change in health care delivery across the country. We are excited to participate in the development of new processes that encourage continuous improvement in quality while finding greater efficiencies in the delivery of care,” said Dr. Tom James, Humana corporate medical director.

In addition to providing technical support in the implementation of ACOs, the Brookings-Dartmouth team will evaluate the pilots to see how ACOs can impact the future of payment reform. The goal is to develop a model that can be replicated across the nation, building on health reform legislation which will likely make ACOs a voluntary option with Medicare participation in 2012.

“We are excited about the launch in Louisville and look forward to expanding the ACO model to other patient populations, including other commercially insured, Medicare and Medicaid beneficiaries,” said Dr. Fisher. “We are hoping that the hard work of Norton Healthcare and Humana will lead the way for other health systems and will be the start of a successful national roll-out.”

About Norton Healthcare

For more than a century, Norton Healthcare’s faith heritage has guided its mission to provide quality health care to all those it serves. Today, Norton Healthcare is the Louisville area’s leading hospital and health care system (44 percent market share) and third largest private employer, providing care at more than 100 locations throughout Greater Louisville and Southern Indiana.

The not-for-profit system includes five Louisville hospitals; 12 Norton Immediate Care Centers; 10,900 employees; more than 400 employed medical providers; and nearly 2,300 total physicians on its medical staff. For five consecutive years, Norton Healthcare has been recognized as one of the Best Places to Work in Kentucky.

The health care system serves patients in the Greater Louisville area, including Southern Indiana, and throughout Kentucky. For more information, visit

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 10.1 million medical members and 7.0 million specialty members. Humana is a full-service benefits solutions company, offering a wide array of health, pharmacy and supplemental benefit plans for employer groups, government programs and individuals.

Humana Using Mobile to Meet People Where They Are.

Humana Inc. (NYSE: HUM) announced today that it is expanding its mobile offerings by introducing three resources for the Mobile Web – via MyHumana Mobile. The new mobile resources enhance a person’s ability to make health care decisions at the point of service and maximize access to Humana’s most effective tools and resources. These mobile tools are:

  • Mobile Urgent Care Finder
  • Mobile Spending Account Balance Viewer
  • Mobile Member Information Tool

Mobile Urgent Care Finder enables a person to find an urgent care facility near them by entering a ZIP code. For smart phones, including the Apple iPhone, the tool uses the device’s built-in GPS feature. Details provided include the facility’s phone number, driving directions and a map. This allows for faster access to the data in an easy-to-use format.

Mobile Spending Account Viewer displays a person’s recent spending account activity and current balance details. Research has shown a greater and more frequent need of balances and account-related information for people using spending accounts, such as Health Savings Accounts or Flexible Spending Accounts. The intent is to have the details available at the point of purchase or service.

Mobile Member Information Tool shows health-plan member details on demand, including the Member ID number and the member’s group name and group number. The Mobile Member Information Tool and each of the MyHumana Mobile resources are designed to meet people’s needs when they’re on the go.

MyHumana has been providing guidance to people for many years. MyHumana Mobile offers a portable extension of that guidance, taking advantage of the features of mobile devices and smart phones, especially the iPhone, BlackBerry, Windows Mobile and Google Android devices,” said Bruce J. Goodman, Humana’s chief service and information officer. “Our mobile strategy provides great flexibility across devices to engage members with a rich experience. Mobile devices are continuing to evolve into a comprehensive and increasingly personal communication platform, and we want to provide the mobile tools our members want and need.”

These resources are available to Humana members today by browsing to from their mobile browser. No additional registration is required as a person’s existing MyHumana login information is used to access MyHumana Mobile.

Mobile applications will be offered soon in 2010 to further improve mobile capabilities for Humana members. Humana’s long-time work to connect with people about their health and wellness is positively influencing the strategy and execution of Humana’s mobile development on three levels including Mobile Web, Mobile Applications and Text Messaging.

Additional Mobile Web features will continue to leverage as the entry for a person’s experience.