Humana is piloting a new care management program that focuses on coordinating care for some Medicare Advantage members who have chronic conditions.
The program is called Humana Care Support. It was formerly known as the Enterprise Clinical Operating Model. Under the Humana Care Support pilot, the insurer’s clinician teams will treat Medicare Advantage members with multiple chronic conditions and complex congestive heart failure and diabetes. The teams include a nurse, pharmacist, social worker and behavioral health specialist, who will work to keep members in their home by bringing care to them.
“Within the Humana Care Support pilot, multi-disciplinary care teams support Medicare Advantage members in achieving their best health by not just looking at the information on their health history that is detailed in their claims, but also at the social and environmental needs that can affect their health,” Humana said in a Feb. 17 news release.
Through the pilot, care teams will use the Salesforce Health Cloud, which Humana said will allow the clinicians to have a centralized view of a member’s health history and clinical workflows. Additionally, Humana will use Microsoft’s Azure and Power BI cloud technologies to run analytics and data integration to give the teams real-time information on members’ health.
The program is running in three states: Kentucky, Pennsylvania and West Virginia. Humana expects to expand the program in 2021.
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