Humana: What Does 2019 Look Like for Health Care

Originally Published by Humana.

In the current environment, constant and negative debate over health care makes it easy for us to be down on our industry. But I’m excited about health care’s potential, and I’m proud of the progress we’ve made.

I believe we are at the pivot point of greatly improving health care. More people are being treated under reimbursement models like Medicare Advantage that incent complete health, not just the delivery of care. In addition, advancements in digital technologies such as home-based monitoring devices and personalized science are increasing the opportunity to leverage the growing sophistication of analytics, artificial intelligence, natural language processing, and machine learning.

Progress today and on the horizon

I’ve seen promising advancements in interoperability, which is empowering patients and resulting in better care. Interoperability gives doctors and other clinicians a complete view of the patient’s medical history, which increases the personalization and timeliness of care interventions.

We have been critical of electronic medical records, but EMRs have digitized millions of paper medical records, increasing the velocity and volume of information and allowing for more complete and timely decisions.

I see parallels in the history of banking. Interconnecting and digitizing bank transactions and implementing interstate banking laws permanently changed the banking structure, creating a more convenient and cheaper system. An example is how stock trades decreased from $75 to $.05 per trade. In health care, that degree of cost reduction would greatly expand the affordability of care and significantly reduce our federal and state deficits.

As I’ve written before, the Centers for Medicare and Medicaid Services (CMS) has challenged the health care industry through the Blue Button initiative, which was designed to drive the necessary, useful interoperability to enable all physicians and all consumers to manage their health online, like they do with their bank accounts and investments.

Patient information needs to be shared, and we can’t encourage business models that impede the process. The good news is we’re moving in the right direction.

Experiencing it myself

For the last few months, I’ve experienced the future of interoperability firsthand by using my Apple Health Kit to download my own health data to my iPhone. Thanks to FHIR, which helps enable this process, I can easily view my patient information from annual checkups to data such as blood pressure, weight and BMI.

Apple Health Records was launched just 11 months ago, and the company has been the first to gain traction on the EMR. Imagine what will happen when more iPhone users like me do this and the 100 million Android users in the U.S. catch on.

Such data doesn’t just help patients; it’s helping the physicians who care for them. At Humana, we’ve asked our 3.5 million Medicare Advantage members for permission to access their Medicare information scripts, doctor visits, etc. We can then use this information to design and price health products specifically for them.

Data sharing, fueled by true interoperability, will stimulate innovation. Yet for adoption to increase, our industry must ensure that the experience is on par with online shopping, travel and financial experiences. In health care, this might show up as a primary care physician having real-time access to a list of all the drugs a patient is taking. That’s especially important in treating seniors, many of whom are living with multiple chronic conditions.

So what’s in store for 2019

More companies will access data to create consumer-engaged business models that encourage competition, foster innovation, and, ultimately, disrupt and force our industry to evolve. We’ll see new and innovative products that help people with their health.

Successful innovations won’t be siloed; interoperability will help physicians make decisions supported by analytics. But technology will only take this so far. It’s up to physician and clinician offices, health plans, and government to help consumers have a real-time, detailed understanding of their health. Physicians, too, will have a truly holistic view of their patients.

Let’s continue to construct a competitive system that fosters a climate of innovation. In the end, we’ll make it easier for physicians to help their patients and for patients to help themselves.