Interview, Fireside Chat
Ross DeVol interviews Paul Kusserow of Humana
- Humana closed an $800 million acquisition in December of Concentra, the largest U.S. workers' occupational health and work-site care company.
- The Concentra portfolio includes 1,100 health professionals, approximately 550 of whom are physicians, alongside urgent care centers.
- The acquisition aims to shift care to alternative sites to reduce unnecessary hospitalizations, which drive costs and complications.
- Global demographics are shifting toward an aging population, with the number of people over 60 projected to increase by 1.2 billion in the next 50 years.
- Conversely, the population under age 5 is expected to decrease by 50 million over the next 40 years.
- Paul Coussereau expresses concern that healthcare reform's ability to handle increased demand is limited by a potential price spiral where "increased demand equals increased cost."
- By 2020, the number of people with insufficient access to physicians is projected to rise from 10% to 20% of the population.
- To meet 2020 demand, an additional 130,000 doctors must be added to the workforce, a gap Coussereau deems "highly problematic."
- Humana plans to address physician shortages by empowering nurse practitioners and utilizing "health extenders" to manage care tasks currently performed by doctors.
- Roughly 85% of Humana's costs are attributed to 15% of its most ill members, leaving a "well bucket" that the company aims to engage through prevention.
- Humana acquired the Vitality wellness program from South Africa to create integrated wellness initiatives offering health literacy, status tracking, and reward systems.
- Humana is deploying "sensors for aging in place" to track daily routines and establish behavioral norms for individuals living at home.
- In partnerships with Intel, Humana Cares is using algorithmic monitoring of biometric and activity data for 50,000 members with congestive heart failure.
- The sensor and algorithm system is designed to send alerts to caregivers when deviations from established norms occur, enabling intervention before hospital admission.
- Technology integration is expected to transform service delivery, allowing nurses to increase daily interactions from four to six visits to approximately 20 via telemedicine.
- Coussereau emphasizes that successful healthcare scaling requires a hybrid model of technology and service, noting that "pure technology won't work" and "pure service" will become prohibitively expensive.