Health & Wellbeing: The Infrastructure for Health

“The goal of a health and healthcare strategy is to find the right intervention for the right person at the right time.”

Humana’s health and healthcare strategy combines community-based health programmes with individually tailored interventions that address health needs, enhance personal choice and promote health and wellbeing. This results in better clinical outcomes, a reduction in resource consumption and fewer complications and side effects.

Humana's health and healthcare services cover five key areas:

Assessment and Planning
Humana’s health and healthcare interventions are introduced in line with evidence of need and inequalities and gaps in current services. These are identified through a combination of public health data (on mortality, morbidity and health inequalities), health services data and interviews with key stakeholders. Based on this information, Humana will work with the PCT to prioritise interventions to improve health and healthcare. Priorities will reflect a balance between local public health objectives, stakeholder opinions, deviation from best practice in local services, cost to the health economy and relevance to the delivery of key national targets. The clinical interventions cover demand management, care coordination, mental health and health and wellness.

Demand Management
Humana’s demand management interventions offer proven, evidence-based methods to deliver clinically necessary care, reduce practice variation and improve patient experience. Interventions include admission avoidance schemes in A&E, in-hospital review to support evidence-based care pathways, enhanced discharge processes and evidence-based assessment of elective referrals and admissions. We also offer pre-admission and post discharge telephonic guidance to support shorter hospital stays and reduce readmissions.

Care Coordination
Humana’s approach to care coordination aims to smooth the transition between different service providers, improve the effectiveness and efficiency of community clinicians and enable people to make informed choices about their health and healthcare. The approach builds on the best of existing community-based services, adding individually tailored guidance and motivational support provided by experienced telephone-based Personal Nurses.

Health and Wellbeing
Humana’s strategy on health and wellness reflects a new view of public health that addresses the needs of populations by understanding the health and health behaviour of individuals. The integration of risk factor reduction, support for self-management and patient engagement into the PCT’s core work creates an environment in which people become motivated to maintain and improve their own health. Humana’s own Health Risk Assessments about personal health and lifestyle can be undertaken to complement and update the data in GP records. The results can support personal health behaviour change and allow predictive modelling of individual and population health risks.

Mental Health
Humana’s mental health strategy starts by assessing current PCT commissioning capacity and reviewing the quality and availability of existing data and information. Early initiatives will focus on understanding existing care pathways across primary, community and inpatient services, improving data quality and building an infrastructure for mental health commissioning. With improved data sources and commissioning skills, Humana offers a cluster of interventions to address variations in the quality and organisation of mental health services. These include integrated case management for physical and psychological health and demand management techniques to reduce variations in inpatient stays and enhance primary care services.

In addition to the above approaches, Humana routinely monitors emerging trends in hospital coding and high risk group claim trends through retrospective audits. When increasing numbers of new codes or new trends are identified, Humana will assist the PCT to discover the root cause, understand the drivers of changed practice, and decide how to address the change in clinical behaviour.

Benefits of Humana’s health and healthcare strategy:

 

For Patients

  • Evidence-based review to tailor care to personal need and reduce unnecessary interventions
  • An ongoing relationship with a highly skilled nurse for people with complex long-term conditions
  • Improved coordination between multiple providers allowing a better experience of care
  • Ongoing information and support for self-management skills (for carers too)
  • Prompts about medications, tests, lifestyle risk reductions and preventative measures to sustain better health

For PCTs

  • A proactive targeted service that supports early intervention in clinical problems and reduced hospitalisation. Savings arise from reduced emergency admissions and shorter hospital stays
  • Evidence-based review of hospital referrals, inpatient stays and community-based clinical management to ensure timely and efficient care and support the earliest possible discharge
  • Links to alternative community services offering other options to hospital admission
  • Post discharge care coordination
  • Reductions in emergency admissions for common conditions
  • Reduced length of stay with reductions in per diem payments for long stay patients
  • Reduction in new and follow-up outpatient appointments
  • Increased PCT influence over the provision of selected interventions through prior approval requirements

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