Disparities of Care in Asthma: Humana’s Solution
Background
Access to medical care services in the United States is often uneven. This leads to disparities in care. Such disparities may be the result of difference in culture, ethnicity, geographical access, health literacy, language or other barriers. This can lead to health outcome differences that are particularly significant for people with chronic illnesses such as asthma.
Humana annually performs in each market an analysis of membership, ethnicity, and cultural composition. The analysis includes any change in ethnicity and cultural composition from the previous year.
Humana’s cultural diversity program seeks to identify disparities among members, target interventions to address disparities, and meet the needs of vulnerable populations with culturally and linguistically appropriate services. This is true for members with asthma as well as with other chronic conditions. Humana recognizes the barriers and has developed a number of programs to help resolve them:
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Access to Care
Humana Communications
Identification and Coaching
Information Kits
Smoking Cessation Programs
Mobile and Web Information
Increasing Access to Care
Humana is careful to provide its members with appropriate access to care, ensuring that primary care providers and necessary specialists and facilities are all within geographic reach. Members can identify providers who meet their cultural and language preference through the Web-based Physician Finder Plus or by contacting a Humana Customer Care specialist. Humana wishes to be sure that geography and language does not become a barrier. This is particularly true for the providers of care to patients with asthma such as primary care, allergists and pulmonologists.
Humana Communications: Meeting Members Preferred Language Needs
Humana works to ensure that multilingual physicians and other providers, where available, and who meet Humana’s standards for quality care are included in the Humana networks. Participating providers are required by Humana to either speak the language of the Humana members or to use translation services to best communicate with their Humana patients.
Humana has a diverse associate base. Health plan associates who have regular contact with Humana members are all enrolled in cultural competence and diversity training so that they may better serve Humana’s membership. Humana’s health educational material, including that for asthma, is available in both English and Spanish. For those who are hearing impaired, Humana provide TTY telephonic service. Humana makes use of the AT&T Language line and can establish three-way calls between member, care manager and a translator. This service is available in 110 languages so that all member needs may be met. Humana’s audio and video libraries, which include information on asthma, are also both available in Spanish.
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High Risk Member Identification and Coaching:
Humana’s proprietary predictive modeling tool identifies members with high health care needs and those at risk. This tool identifies members with significant asthma just as it does identify members with other chronic conditions. Once identified the member with asthma will have a telephonic assessment by a Humana nurse, who has received cultural competence and diversity training. The Humana health care professional associates have all been trained on assessing the educational level and cultural preferences of the member, and are able to meet their needs. This will allow for health coaching that is appropriate for the member with asthma.
Asthma Information Kits:
Humana’s nurses may provide the member with an asthma education kit that includes a spacer and a peak flow meter. These devices that are important for proper asthma care may not otherwise be accessible to the member with asthma. These kits are available in English and Spanish. Humana health care professionals help the member understand how to use these devices and how to provide self-guided care.
Smoking Cessation:
Studies have shown that tobacco smoking has a higher prevalence among indigent and certain ethnic populations. To address these needs, Humana provides smoking cessation programs that are in English and in Spanish.
Mobile and Web-based Information:
Research has also shown that the utilization of mobile phones is especially prevalent in the Hispanic community and in the inner city. For the member with asthma, Humana has created mobile capabilities that provide much of the same information as found on its website (and more). For example, Humana members with asthma are able to access from either Humana’s mobile application or website information on drug pricing. Members may receive medication reminders through text messaging. Members also receive reminders for drug refills and can even refill their asthma medicines on line or through the Humana app.
Through identification of members at risk, providing culturally and linguistically appropriate clinical interventions, and communication access via member-preferred media, Humana is striving to reduce the disparities of care for its members with asthma.
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