Humana 2020 2015 progress report

Our commitment to serve Bruce Broussard Humana’s President and Chief Executive Officer

Several years ago Humana broke new ground when we announced that, as a health enterprise, we would be guided not by a mission statement or a vision statement – but by a dream. Our dream is to help people achieve lifelong wellbeing. This has motivated, inspired, and engaged our 57,000 associates when they come to work at Humana every day. Even more importantly, it has resulted in measurable health improvement for many of our 14 million medical members across the country.

Over time, we came to realize that, though powerful, our dream is not enough. In order to achieve it, we understood we would have to measure it – to make it “a dream with a deadline.” Today, we are making public the bold goal we have set for ourselves: To improve the health of the communities we serve 20 percent by 2020 by making it easy for people to achieve their best health. Why do we put such emphasis on “making it easy”? Because as a society, we have made health hard. Our convenience culture (fast food, sedentary entertainment) has created barriers to good health that must be overcome if we’re to achieve our bold goal. These include a wasteful, inefficient health care system that rewards procedures performed rather than health

outcomes achieved; lack of affordable access to care; fragmented care delivery; lack of technological interoperability; communities and environments that make healthy eating and exercise challenging; and insufficient engagement by individuals when it comes to taking responsibility for their own health improvement. Humana is dedicated to closing this gap that has developed between people and care. Our goal holds us accountable for doing so. This report is the first in a series of updates that will periodically describe how we’re doing. In this report, you’ll see examples of where we’ve already made progress in making health easier, particularly among Humana associates. You’ll hear of inspiring partnerships we’re building in places like San Antonio, Texas and Natchez, Mississippi, where entire communities are becoming focused on the goal of measurable health improvement. And you’ll read about how we’re using the “Healthy Days” measure – developed by the Centers for Disease Control and Prevention (CDC) – to track and measure our overall progress. We invite you to keep up with us and our partners over the next six years as we strive to bring healthy, positive change to the communities and people we serve.

Our goal: The communities we serve will be 20% healthier by 2020 because we make it easy for people to achieve their best health

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Our approach Integrated Care Delivery Model So, where do we start with our goal of improving the health of the communities we serve 20 percent by 2020? It starts with our strategy: offering Humana health plan members access to quality, affordable health care services through a consistent, best-in-class consumer experience. Our Integrated Care Delivery Model is the engine of this strategy, which uses sophisticated data analytics to provide effective, seamless, personalized care with high member engagement. What does this look like in action? Take Humana At HomeSM, a program where we send care managers into the homes of members who have multiple chronic conditions to develop a more holistic approach to their health. This model is very effective for members who are managing chronic conditions like severe diabetes or congestive heart failure, which require adopting new regimens around medications, diet and other changes in

We not only prescribe this approach... we live it. Best Employers for Healthy Lifestyles Platinum, 2014 National Business Group on Health

daily living. The care enables us to help our members not only maintain their quality of life but also remain independent in their homes.

Integrated Care Delivery Model

This holistic approach to member-centered care is also reflected at our Clínica Asociación Cubana (CAC) Florida Medical Centers, where our geriatrics experts provide routine medical and ancillary care services “under one roof,” all orchestrated by primary care physicians. CAC and Humana At Home are proven ways that Humana is making it easy for people to achieve their best health. It’s the future of care, available today. To ensure our approach is effective, we have to measure it, thus measurement is an important element of achieving the goal. We’re using a proven instrument developed specifically for population health management known as “Healthy Days.” Developed by the Centers for Disease Control and Prevention (CDC), the measure asks people to self-rate their health as well as recent days of physical health, mental health, and activity limitation. We believe Healthy Days is a good measure of the effectiveness of our Integrated Care Delivery Model and we explain the measure in great detail later in this report. Our vision is a health care system that revolves around individuals and their primary care physicians, the essential foundation for achieving our bold goal. For too long, both people and the health care system itself have suffered from an emphasis on sickness rather than health. Humana is working to change that and measure the change as we go.

The role that technology plays during this transformational moment for Humana and our members is intricately related to the ultimate success of our journey toward becoming a consumer-focused health and well-being company and achieving our bold goal. With an integrated technology strategy that encompasses the macro trends of mobile, social, cloud and analytics, we’re better able to reach and understand our customers, and provide them the tools they want and need, ultimately enabling people to make better decisions and create better health outcomes. – Brian LeClaire Humana’s Chief Information Officer

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5 key points of influence As one of America’s leading health and well-being companies, Humana has the reach and the resources to simplify the health care system and better support the way physicians, clinicians and other health professionals deliver care. As we pursue our bold goal we’ve identified five key points of influence where our integrated approach to care has the most impact on improving people’s health:

Wellness and Prevention

Programs like HumanaVitality® – an incentive-based wellness rewards program with more than 3.8 million members, including many Humana associates – provide education, resources and coaching for people to make better daily choices that can improve their physical and mental health today and in the future. HumanaVitality knows that to effectively motivate individuals to achieve healthier actions, wellness programs have to work hand-in-hand with members, leading them through the process of understanding their health status, choosing improvement or maintenance goals, staying motivated and relying on verifiable data to reward their accomplishments. From 2012 to 2014, Humana associates who enrolled in Vitality had lower health costs and fewer work absences than those who didn’t.

Primary Care

Health care relationships between physicians and their patients are critically important. Physicians know their patients’ health. As more and more people in the U.S. struggle with chronic conditions that require ongoing care management, these relationships are more critical than ever. That’s why we’re increasing our investment in primary care delivery. Humana has relationships with more than 42,000 primary care providers either directly employed by the company or working with Humana through contracts and joint ventures. We’re making it easier to connect these doctors with their patients.

Pharmacy

Humana Pharmacy Solutions® provides affordable medications to our health plan members. We want to ensure our members get the prescriptions 4

62%

of our new Medicare Advantage members for 2014

had wellness screenings via a Health Risk Assessment

they need when they need them. Our research shows Humana Pharmacy Solutions customers take their medications as prescribed at a higher rate and have lower out-of-pocket costs than customers who obtain their prescriptions in retail locations. Last year we processed approximately 330 million prescriptions; we dispensed about 30 million of these prescriptions.

Home Health

People who face the greatest health care challenges need a comprehensive, full-service approach. That’s why Humana offers in-home care, telephonic health counseling/coaching, and remote monitoring, among other programs. A recent two-year study showed that, on average, our Medicare Advantage members enrolled with Humana At Home lived longer than those who were not enrolled.

496,000 more days at home

for newly managed Humana Chronic Care Program members

By addressing the scope of needs of people living with chronic health conditions, including help with daily activities, we are making a profound impact on their quality of life and enabling them to remain independent at home. – Eric Rackow, M.D. “Humana At Home” Leader

Informatics

One of Humana’s highest priorities is to harness the power of data and analytics to improve the health of Americans and the system that cares for them. Humana’s analytics operations review millions of clinical data points each day. Using social media, smartphone apps and other tools, Humana provides members, health care providers and health care companies real-time clinical insights to address gaps in care, improve health outcomes and reduce costs. In 2014, Humana used its data analytics capabilities to detect 4.3 million instances where necessary care (for example, an eye exam for a person with diabetes) had not been given; we alerted members and their physicians and followed up until the gaps were closed. In addition, we also identified 1.9 million high-risk members through predictive models.

92%

of Humana Medicare Advantage members are covered by a health plan that has a

Stars Quality rating of 4.0 or higher

*Centers for Medicare and Medicaid Services Quality Rating System

How we’re improving care Population health

To improve the health of the people and communities we serve, Humana is focused on helping physicians drive improved health outcomes for all of their patients. This “population health” approach will equip physicians to succeed in a new health care environment as the U.S. population ages and chronic health conditions continue to challenge our society. In mid-March, Humana announced the formation of Transcend™ and Transcend Insights. Transcend provides resources in care coordination, financial risk management, clinical integration and patient engagement that help physicians improve the patient experience as well as care outcomes. Transcend Insights provides health care systems, physicians and care teams with advanced Internet-based interoperability, real-time health care analytics and intuitive care tools to simplify the complexities of population health.

Rewarding for results

A key part of Humana’s population health approach is to help physicians evolve from health care’s current fee-for-service payment system to a value-based system. The traditional, long-standing fee-for-service model pays physicians for each activity they perform; it does not pay them for measurably improving the health of their patients. Within the fee-forservice system is an inherent conflict: the more services physicians and other care professionals provide to their patients, the more they are paid. Fee-for-service does not reward physicians for helping their patients achieve their best health.

As a result, people sometimes receive care they don’t need. Additionally, ongoing primary care management for people with chronic conditions often receives insufficient emphasis and attention. Humana and others have begun to implement a solution to this problem: a value-based model that promotes highquality care based on what research and studies have shown to be most effective in improving health. Already in wide use in the Medicare Advantage program, our approach to value-based physician payments, sometimes called accountable care, has helped more than 1.3 million of our Medicare Advantage members get on the path to better health. At Humana, part of integrated care means embracing this value-based approach to managing our relationships with care providers.

Trusting partnerships

Humana is partnering with more than 42,000 primary care providers in valuebased arrangements. We’re helping these physicians and others incorporate best practices in care management. This includes provider analytics tools that show real-time identification of gaps in care while a patient is present in the physician’s office, at a clinic or in the hospital. This enables us to take key steps forward when it comes to achieving our bold goal.

We’ve still got a long way to go. Humana expects to have 75 percent of our individual Medicare Advantage (MA) members covered under this value-based payments approach by 2017. Ultimately, this new paradigm has the potential to transform the health care system, rewarding doctors, hospitals, and other providers according to assessments of how well patients do under their care.

Researching to drive change

Humana’s aspiration to revolutionize American health and American health care also extends to the field of research. At Humana, we’re conducting our own population health studies and partnering with prestigious academic institutions and private foundations to contribute to systemic change. In the past year, Humana researchers have presented health research findings at events sponsored by the American Public Health Association, the Academy of Managed Care Pharmacy and the American Society of Clinical Oncology, among others.

We understand that the transition from fee-for-service to value-based for physicians will not come overnight. Our goal is to offer programs to meet these physicians where they are in their practices and support them as they move toward a value-based approach.

Our results show that physicians who we’re partnering with in valuebased arrangements are getting better quality scores and better health results for their patients. – Roy Beveridge, M.D. Humana’s Chief Medical Officer 5

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Measuring the health of the communities we serve Healthy Days

A consumer-focused measure of health

Measuring the impact of our Integrated Care Delivery Model and the health of communities we seek to make healthier is

a key component of Humana’s bold goal. It was important for us to identify a clinically-focused scientific approach that provides sufficient information, yet is simple enough to collect the necessary data and to measure our progress. We wanted to ensure that we know whether the people we serve are improving their health and well-being. There is no silver bullet or absolute standard for the measurement of the health of a community. Health is not simply the amalgamation of diagnoses made by a patient’s clinicians. It must also reflect the patient’s perception and feelings about their own health. A cross-functional team of Humana clinical and analytics leaders along with national experts from the academic and public health worlds performed a review of existing measures of population health,

Measuring the health of the communities we serve* 6.7

Physically unhealthy days

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4.3

Mentally unhealthy days

unhealthy days

2020 Goal improve by 20% to

8.8

unhealthy days

Goal is a 20% reduction in average unhealthy days from the baseline by the end of 2020. 6

*Includes Humana members in our Medicare Advantage, HumanaOne, and Employer Group Plans. Total sample size of 133,773 respondents.

seeking a measure that was reliable, actionable, externally recognized, clinically relevant and simple. After reviewing the available options, Humana determined that the Centers for Disease Control and Prevention (CDC) instrument known as “Healthy Days” was the tool that best suited our needs. The Healthy Days instrument was developed by the CDC to measure population health. Healthy Days asks people about general self-rated health and recent days of physical health, mental health and activity limitation. The Healthy Days instrument includes a total of four questions. Two of these questions, which ask about physical and mental health over the previous 30 days, are used to derive an index of unhealthy days that form the Healthy Days measure:

CDC Healthy Days is a simple survey that is easy for people to understand and answer, yet provides a valid summary health-related quality of life (HRQoL) measure to assess how a person perceives her or his recent physical and mental health. – Haomiao Jia, PhD Associate Professor at Columbia University, Department of Biostatistics

1. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? 2. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? Since 1988, the CDC has been asking over 450,000 Americans per year these questions and tracking the Healthy Days measure. It has also been used by other population health experts, including academic thought leaders and practitioners, such as the Robert Wood Johnson Foundation and the University of Wisconsin. The questionnaire has been shown to deliver reproducible results, to provide a holistic view of a person’s health, and to capture perceptions of health regardless of age, gender, race, or clinical condition. In addition, self-assessed health status has been proven to be a more powerful predictor of mortality and morbidity than many clinical measures of health. Two decades of studies, and our own experience, confirm that the Healthy Days measure is highly correlated to actual clinical health.

Measuring our goal

Using the Healthy Days questions, Humana partnered with population health experts to develop our survey methodology. To measure progress against our goal of making communities 20 percent healthier, we will survey a statistically valid random sample of members from our major medical lines of business where we have influence over members’ overall health. This includes members who have Medicare Advantage plans, plans purchased through the individual exchanges and plans offered through employers. During the fourth quarter of 2014 Humana conducted surveys to establish Healthy Days baselines for members in these key medical lines of business. In addition, we have established Healthy Days baselines in geographic communities where there is significant Humana health plan membership. We will continue to measure the health of our communities annually through 2020 using this methodology, and our progress toward the goal will be measured by the reduction in unhealthy days from the baselines.

It’s important to remember that every population is made up of individual people. That’s why it makes sense that we ask individual members of these communities a version of the basic questions we ask anyone we care about: ‘How are you feeling? How have you been?’ – Jody Bilney Humana’s Chief Consumer Officer

We know that our bold goal will require us to learn and innovate. We believe that the next one to two years will be learning years where we work with specific populations to generate new insights and discoveries on how to improve health. We expect these learnings will allow us to make great strides during the latter years of our journey toward our goal.

Measuring our progress is essential to achieving this bold goal. It is how we quantify our commitment to our associates, our members, and the communities where they live. – Lisa Stephens “Humana 2020” Director, Measurement 7

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Impacting the health of our communities Our goal centers on communities because we know that good health depends on access to healthy foods, safe places to exercise, and opportunities to engage in meaningful activities that inspire us to keep our healthy habits. As we’ve begun to work in key communities with local leaders, Humana members, and our associates, we’re beginning to see the change we knew was possible. – Emily Allen Kirby “Humana 2020” Leader

Beginning our journey

Humana’s bold goal centers around communities because we recognize that health care happens in the physician’s office and in the hospital, but health happens in the communities in which we live. The health of individuals is influenced – for better or worse – every day by those around us. This is particularly true in the current era when many of our country’s health challenges are driven by chronic conditions – like diabetes and cardiovascular disease – that require changes in lifestyle to manage and improve. To begin the journey that will take us to 2020, we have focused energy and resources on a few key communities. Our goal in these communities has been to learn how we can bring our integrated care model and clinical capabilities and leverage them in partnership with local leaders and entities that seek to improve health.

The approach we develop and learning we generate in any one community can be used broadly to impact all the communities Humana serves. For several years, Humana has been working with the “community” of its own associates to improve their health and well-being. That’s the first population where we hold ourselves accountable for demonstrating improved health outcomes. In Bell County, KY, we’ve worked for many years to drive better health through peer group teams and have learned much in the process.

We want to invest in our teammates – we’re better able to serve other people when we do that. – Tim Huval Humana’s Chief Human Resources Officer

Mississippi is a new community of focus for us, and over the past year we launched significant activity there with the Bill, Hillary and Chelsea Clinton Foundation. A third community is San Antonio, where Humana has over 500,000 health plan members and believes that with the support of the city’s leadership we can change the trajectory of health. Our work in these communities allows us to address health both in physicianled settings as well as community-based settings, and it is teaching us what it takes to make communities healthier.

What makes us healthy*

50 % 8

healthy behaviors

20 % environment 20 % genetics 10% access to care

What we spend on being healthy*

88% medical services 4% 8%

healthy behaviors other

*Bipartisan Policy Center

Our associate community

A powerful transformation in how Humana associates live and do business together continues to gain momentum. Since our founding 54 years ago, the heart of Humana has been about taking care of people, and today we’re in the midst of a multi-year journey to achieve our own best health and well-being. It’s a journey that is coming to life as a vibrant social movement that can be described simply as: “be the best me and be the best we.” As a community, our associates are united in their focus on the power of health, and we understand that physical health alone is but one aspect of our journey together – health and well-being are also about how we feel. We believe that well-being is holistic, so better health also comes from the comfort of security, the excitement of purpose, and the confidence of heartfelt belonging. It’s about living happy and living healthy. Taking better care of ourselves – physically and emotionally – is one meaningful way we advance toward the organization’s bold goal. We understand that it not only has an

impact on us as an associate population, but it also makes us better able to serve the communities of Humana members and patients we care for. That’s why we have committed to lead the way with our associate community so that we ourselves are 20 percent healthier by 2017. Living happier and healthier can be hard, but at Humana we’re doing it. As a community, our associates reversed the trend toward declining health by taking action, making better choices, and improving our sense of purpose and belonging. When we look at insights from our recent study of associates employed since 2012, the results* are powerful: • Four out of ten associates have decreased their number of health risks closely linked to the development of chronic disease and another three out of ten have sustained their levels. • Overall, the number of average health risks per associates has decreased 8 percent since 2012. • Associates who started exercising regularly reduced their health risks by 16 percent.

• Among associates with diabetes, those who developed a higher sense of belonging were less likely to develop complications. Our journey with our associate community has reinforced the notion that health happens where we live, work, learn, and play. It happens when we’re connected to the people, the reasons, and the care that are meaningful to us.

While I try to do all the right things throughout the year, I find the daily demands of work and home often overshadow the common sense of maintaining mind, spirit and body. The 100 Day Dash actually gives me the right push to get me refocused on walking and running. Truth be told, I look forward to the Dash because it reminds me of my commitment to take action on my biometric results. – Jim Koeppel Humana Clinical Care Services Director

194,000 pounds lost

It’s evident we’re taking better care of ourselves, but we’re also caring about each other. The reason seven out of ten of us have either improved or maintained our health over the past two years is a combination of positive lifestyle changes and vibrant social support within our community.

by Humana associates who improved their health

– Tim State Humana’s Associate Health and Well-being Leader

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*Results represent Humana Health Plan data through December, 2014.

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Bell County, Kentucky

Some 200 miles southeast of Humana’s headquarters in Louisville, Bell County, KY, has among the highest obesity and diabetes rates in the nation. But over the past three years, through a cooperative program known as Team Up 4 Health, Humana and the non-profit organization Microclinic International have reduced these rates appreciably in a pilot group of local residents. The Team Up 4 Health program emphasizes the power of making small behavior changes to achieve better health and well-being. Peer-to-peer influence and the power of community are key components. We believe good health can be contagious, so we’ve created support groups, a community garden, and educational programs that are slowly changing the mindset – and health prospects – for the 28,000 people who call Bell County home. The program has followed a simple but effective process: • Participants were recruited throughout the community. They were screened for risk factors such as BMI, cholesterol, and blood glucose levels.

The results have been impressive: • Ninety-five percent of participants who completed the program realized at least one health improvement out of five health measures: BMI, waist circumference, blood pressure, cholesterol, and/or blood sugar level. • Participants lost weight, with obese participants losing 10.2 pounds on average. Eighty-two percent of participants reported increasing their physical activity.

49%

were eating healthier by the end of the Team Up 4 Health program

By the end of the program, 49 percent of participants reported eating healthier.

I’ve learned a lot. It’s opened a whole new world. I didn’t realize how easy it would be to get into a healthier way of living and stay with it. It was like a lifesaver for me. – Willene Black Team Up 4 Health Program Participant

82%

of participants in Team Up 4 Health reported

increased

physical activity

• At-risk individuals were enrolled in the program and met biweekly for 10 months. • Participants learned, shared and adopted practical health behavior changes. • The group engaged in interactive activities such as learning how to read nutrition labels, participating in exercise classes, and attending Q&A sessions with medical specialists.

10.2

pounds

average weight loss by participants of Team Up 4 Health in the Bell County, KY area 10

Team Up 4 Health follows a simple notion – people facing chronic diseases such as hypertension, obesity, heart disease or diabetes can make small behavior changes and see powerful results that lead to better health and lifelong well-being. By harnessing the power of community – through existing social networks and positive peer-to-peer influence – we’ve helped people adopt and spread healthy behaviors. – Heidi Margulis Humana’s Corporate Affairs Officer

Mississippi

As the health care exchanges launched in 2013, there were 36 counties in Mississippi where no health coverage was to be offered through the exchanges. Humana stepped in and filled that gap by offering exchange-based health plans to individuals in those communities. Through that commitment, we began to engage with state and community leaders in a new and different way. Eventually, we engaged deeply with Adams County and its county seat of Natchez, on the banks of the Mississippi River. There we found a community that struggled with health, but leaders and residents who really wanted to make change happen. In November of 2014, Humana and the Clinton Foundation’s Health Matters Initiative announced a partnership to help make Adams County, Mississippi 20 percent healthier by 2020.

I’m excited about this partnership because it holds great promise not only for Adams County but for the rest of the state and other communities, both rural and urban, we serve across the nation. We’re confident the lessons we learn in Adams County will help us find health solutions for other communities as well. – Erik Eaker “Humana 2020” Director, Partnerships

The Clinton Health Matters Initiative (CHMI) uses a model that focuses on social determinants of health – such as food and nutrition, infrastructure (e.g. walking paths), education, financial welfare and access to care. To address these issues, the Foundation brings together a diverse group of stakeholders to discuss challenges and commit to a set of “bold actions” the community will take over a five year period. On December 3, 2014, CHMI hosted the Adams County Blueprint for Action Day in Natchez. The event drew 120 community attendees representing a variety of backgrounds and organizations gathered to brainstorm and prioritize health challenges within the community. As an outcome of this event, these leaders are identifying the top 40 bold actions they will implement to improve the health of Adams County. The partnership’s Blueprint for Action will be published this spring as local and national entities begin their work.

The No. 1 threat to the health of Adams County is obesityinduced diseases such as type 2 diabetes and heart disease. We intend to use our partnership with Humana and our community-led collective impact model to address this threat by implementing evidence-based lifestylechange interventions. Such an undertaking will have a long-term effect on the overall health of the people of Adams County. – Getty Israel Clinton Foundation, Mississippi Regional Director

When I learned that my company wanted to invest in Mississippi, the state where I am raising my family, I was over the moon. Mississippians deserve the highest quality of care and I am proud to work for a company that is truly working to close the gap between people and the care they deserve. The next five years of learning will be important and will shape the future of health in our state. – Stacey Carter Humana’s Mississippi Sales Director

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San Antonio, Texas

In 2014, Humana put significant focus on the city of San Antonio where we have the potential to impact over 500,000 Humana members and beneficiaries, over 165,000 visitors to Humana clinics, and 1,300 Humana associates.

Healthy people help drive a stronger, more effective health care system. The challenge is that being healthy can be hard for all of us, which is why Humana is so committed to partnering with people and communities to help them get healthy and stay healthy. Healthier communities mean a healthier Humana. – Pattie Dale Tye Humana’s Project San Antonio Leader

In July of 2014, Dr. Sandra Delgado, a San Antonio resident who is the Chief Medical Officer for Humana’s Government Business, began efforts to foster collaboration among San Antonio health leaders and influencers. She and Humana’s Chief Medical Officer, Dr. Roy Beveridge, hosted a Clinical Town Hall that was attended by over 100 Humana and community participants who engaged in discussions on overcoming barriers to health and making it easier for San Antonians to achieve their best health. The outcome of that session was the establishment of the San Antonio Health Advisory Board (SAHAB), a group of local clinicians and community leaders who are committed to working together with Humana to improve the health and well-being of San Antonio. Partners include key local organizations such as

Methodist Healthcare, the San Antonio Food Bank, the mayor’s SA 2020 initiative, the Bexar County Medical Society and San Antonio’s Metropolitan Health District. Our partnership with the city’s largest grocer, H-E-B is off to a great start. Collectively, we seek to promote wellness by addressing nutritional and behavioral barriers with our H-E-B My Health, My Way partnership. The My Health My Way partnership with H-E-B addresses the barriers that keep consumers from eating well in San Antonio: cost, convenience, and culture. These barriers are being addressed by programs that change individuals’ relationships with food, such as Healthy Meals, which promotes healthy cooking and eating by offering (1) weekly healthy and inexpensive recipes that include shopping lists and coupons, and (2) access to H-E-B’s certified nutritionists to Humana associates and members. Because San Antonio has a diabetes rate that is significantly higher than the national average, much of our work focuses on preventing or slowing the progression of

Promoting wellness

with local partners like H-E-B, San Antonio’s largest grocer

As we look to the future, we are working on new solutions for our customers that can help them overcome their health barriers and live more active and fulfilling lives. – Chris Kay Humana’s Chief Innovation Officer 12

Potential to impact over

500,000

Humana members and beneficiaries

to 165,000 visitors Humana clinics associates 1,300 Humana in San Antonio

this condition. We are piloting in-person solutions to help address the needs of our members who have, or are at risk, for low-severity diabetes. Key pilots include:

The fact that Humana is partnering with other leaders in the health industry is a testament to our level of our commitment to improve all the communities we serve.

• Programming in our Las Palmas Guidance Center where members can attend Diabetes education and healthy cooking classes, meet peers for support and participate in physical activities like Humana’s walking program. • Health Guides who contact new members by telephone to help them optimize the use of their health plan for appointments, supplies and medications as well as engage with community resources focused on diabetes. • A program with select physicians to enable them and their patients to maximize compliance with recommended diabetes protocols, such as regular blood level testing, eye exams and foot exams. Lastly, we are engaged in efforts to truly integrate care for San Antonians through shared data and patient information that gives all clinicians in the community a full 360-degree view of their patients.

– Sandra Delgado, M.D. Humana Medical Director and SAHAB Board Chair

Members really appreciate the guidance we provide them in managing their diabetes. There is too much information for them to focus on and we, as Health Guides, are able to provide the right resources to improve their health. – Rosemary Lopez Humana Health Guide, San Antonio

With key partners, we are developing a Health Information Exchange platform that will allow information sharing between Humana-employed clinicians as well as other local providers and hospital systems across the market. This connectivity enables the sharing of critical health information to help improve the consumer experience and clinical outcomes for the San Antonians we serve.

The SAHAB provides a unique opportunity to bring the Medical Care and Community Health Communities of San Antonio together to improve the health and quality of life for San Antonio. – Peter Wald, M.D. Vice President and Enterprise Director of USAA and SAHAB Vice Chair 13

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Conclusion

Humana is deeply committed to improving the health of the communities we serve 20 percent by 2020, and we will do this by making it easy for people to achieve their best health. Our bold goal not only provides us with the metric we’ll use to hold ourselves accountable, it also provides us with the method we’ll use to close the gap between people and care. We’ve begun to pursue the goal by providing integrated care, outstanding clinical capabilities, and a personalized consumer experience that start to make it possible for people to achieve their best health. But we

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know we can’t do this work alone. Achieving our bold goal will take long-term partnerships in the communities we serve. We seek to co-create and pilot innovative solutions with partners based on a deep understanding of communities. Every day, Humana’s 57,000 dedicated associates are focused on making our goal a reality. We are looking forward to combining the power of their commitment with that of other like-minded, health-inspired people and organizations who share our values and want to make a real difference in American health.

Our values In pursuit of our bold goal, Humana will be guided by its core values.

Inspire health

We inspire health by making conscious choices every day and motivating others with our positive example. We care about each other and actively contribute to an environment of well-being.

Cultivate uniqueness

We find ways to connect with each other and our consumers. Respecting one another, listening with an open mind, and seeking different perspectives results in richer solutions.

Rethink routine

Innovation emerges from a culture that cultivates curiosity. We spark creativity by challenging ourselves to think differently.

Pioneer simplicity

We make life easier and believe that less can be more. When we empower associates with responsibility, we are able to create an agile organization and an exceptional experience.

Thrive together

We focus on shared success by breaking down silos, inviting collaboration and mentoring others. We believe in, and act with, positive intention to create an environment of trust and integrity.

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