Healthy Behaviors Yearly Program Review

Go365 for Humana Healthy Horizons^® is a wellness program that offers members the opportunity to earn rewards for taking healthy actions. We know living and aging well is important, so we designed our Healthy Behaviors program to:

• Encourage and reward healthy behaviors
• Help members take steps toward being and staying healthy
• Help members reach their health and wellness goals

It is easy to participate in healthy activities and earn rewards through our Go365 for Humana Healthy Horizons wellness program. To earn rewards, members must:

• Download the Go365 for Humana Healthy Horizons app from iTunes^®/Apple Store^® or Google Play^® on a mobile device
• Create an account to access and engage in the program
  • Members who are 18 and older can register to create a Go365 account. Members must have their Medicaid member ID.
  • Members under the age of 18 must have a parent or guardian register on their behalf to participate and engage with the program. The person completing the registration process on behalf of a minor must have the minor’s Medicaid member ID.

Members who have a MyHumana account, can use the same login information to access Go365 for Humana Healthy Horizons, after they download the app.

Our Healthy Behaviors Program includes 11 types of activities that eligible members can complete to earn a reward:

1. Health risk assessment (HRA): Rewards all members when they complete the HRA.
2. Well-Child Visit: Rewards members under 18 years old when they complete a wellness visit with their primary care physician (PCP).
3. Adult well visit: Rewards members 18 years and older when they a wellness visit with their PCP.
4. HumanaBeginnings™: Rewards members 13 and up who enroll and complete our HumanaBeginnings Program offering them prenatal and postpartum education and care management to help decrease the risk of pregnancy complications (such as preterm delivery) associated with high-risk pregnancies. In addition, members are also rewarded when they get a prenatal care visit and a postpartum care visit.
5. Weight management: Rewards members 12 years and older who enroll in the program and complete 6 telephonic coaching sessions with a health coach. Members must complete a well-being visit with their PCP prior to enrolling in the program.
6. Tobacco Cessation: Rewards members 12 years or older who complete 8 telephonic coaching sessions to help them quit smoking or vaping. Complimentary Nicotine Replacement Therapy (NRT), like patches, gum, and lozenges, is only available to eligible members 18 years and older.
7. Substance Abuse: Rewards members 18 or older who complete 6 telephonic coaching sessions with a Substance Abuse Coordinator or actively participate in an outpatient program for 28–30 days to help them live a drug- and/or alcohol-free life. Members have a choice to participate in 1 or both programs.
8. COVID-19 Vaccine Program: Rewards members 18 years and older and parents/guardians for members 6 months to 17 years old a reward when they get the complete COVID-19 vaccine and upload a picture/file of their completed COVID-19 vaccine card on Go365.
9. Mammogram Screening: Rewards members 40 years and older when they get an annual mammogram screening. Members less than 40 years old and at high-risk are also encouraged to have an annual screening. A Physician written order (referral) may be required for mammogram screening. Members are encouraged to check with their Primary Care Physician or OB/GYN.
10. Cervical Cancer Screening: Rewards members 21 years and older when they get an annual cervical cancer screening. Members have open access for OB/GYN visits and do not require a referral from a Primary Care Physician.
11. Colorectal Cancer Screening: Rewards members 45 years and older when they get an annual colorectal cancer screening. A Physician written order (referral) may be required for colorectal screening. Members are encouraged to check with their Primary Care Physician.

The below clinical success measures reflect program and/or activity completion dates between July 1, 2022, and June 30, 2023 (and rewards paid through July 31, 2022). We compared data for members who enrolled in and completed one or more programs with our members who did not enroll into a Healthy Behaviors Program.

Health Risk Assessment (HRA)

• Overall, we completed 64,606 HRAs for members of all ages
  • The contract requires us to complete an HRA on 70% of pregnant enrollees and 50% of enrollees with diabetes, asthma, and serious mental illness. We completed 6,293 HRAs on members we were able to contact with these four health conditions.
    • Eligible members who were identified with asthma and/or diabetes were referred to Humana’s Disease Management programs with the goal of improving health outcomes by assessing their needs and implementing interventions to assist members with complex medical needs.
    • Eligible members who were identified as pregnant were referred to our HumanaBeginnings program where they engage with case managers to help improve birth outcomes and encourage prenatal and postpartum visits.

Well-Child Visit

• The Well-Child Visit Program is designed to encourage and reward all members who are under 18 years to visit their Primary Care Physician (PCP) for an annual/wellness check-up, preventive screening, and necessary immunizations.
  • We saw a 212% increase (226,891 members) in Well-Child Visit when compared to prior fiscal year (72,643 members), because we included additional claim codes to the program.

Adult Well-Visit Program

• The Adult Well-Visit Program is designed to encourage and reward members who are 18 years and older to visit their Primary Care Physician (PCP) so their PCP can perform a thorough screening, examination and assessing of medical needs for the member.
  • We saw a 713% (45,936 members) increase in Adult Wellness Visit when compared to prior Fiscal Year (5,653 members) because we added several claim codes to the Program.

HumanaBeginnings Program*

• The HumanaBeginnings Program is designed to provide health education and care management to pregnant members 13 years and older to decrease the likelihood of pregnancy complications, including preterm delivery associated with high-risk pregnancy.
  • We saw a 48% (3,882 members) increase in completed rate in the HumanaBeginnings Program when compared to prior Fiscal Year (2,626).
  • Members engaged in the HumanaBeginnings Program had an 11.8% preterm delivery rate, which is 3% (12.2%) better when compared to the general population.

*Members who are enrolled in the HumanaBeginnings Program have higher comorbidities, such as hypertension and behavioral health issues, than those who are not enrolled. In addition, enrollment in the HumanaBeginnings Program increases members’ timeliness of prenatal and postpartum visits, helps to close gaps with Social Determinants of Health, assesses Behavioral Health needs and provides access to Behavioral Health providers.

Tobacco Cessation/Weight Management programs/Substance Use

Because smoking, substance abuse, and weight management can cause adverse health outcomes and complications years or even decades after the successful completion of a program, measuring program efficacy is difficult during a 12-month period. To enconrauge long term behavior change and sustainability of efficacy, we increased health outcome education regarding the consequences of these conditions for members as they enroll and complete any of these three programs. We saw a 49% (79 members) increase in completion rate on the Tobacco Cessation Program when compared to prior Fiscal Year (53 members). For the Weight Management Program, we also saw a 127% (109 members) increase in completion rate when compared to Fiscal Year (48 members). We saw a 11% (24 members) decline on the Substance Abuse Program when compared to prior Fiscal Year (27 members).

Mammogram Screening/Cervical Cancer Screening/Colorectal Cancer Screening

Since we added these three programs on January 1, 2023, to our existing suite of Healthy Behaviors Programs, we are unable to provide any outcome measurements at the time of this report.

To continuously promote member engagement and improve health outcomes, we have increased efforts to promote and enroll members into the Healthy Behaviors program via year-round, robust, omnichannel tactics, including a welcome kit, email, text, social media, webpage, outbound calls, educational flyers, and videos.

We also continue to collaborate with the Agency for Health Care Administration, vendors, and other community engagement programs to help improve the health and well-being of our members.

At Humana Healthy Horizons in Florida, we continuously look for opportunities to help our members live and lead healthier lives. We do this by incorporating members’ feedback into existing Healthy Behaviors Programs and adding new programs.