Humana CMO on the role of AI in an integrated care landscape
One of the nation’s largest healthcare companies, Humana, has a new chief medical officer. The Louisville, Kentucky-based healthcare company describes itself as being on the bleeding edge of integrated care, with its acquisition of home healthcare company Kindred last year and its ever-growing share of the Medicare Advantage market.
With a heavy presence in value-based care, bringing community resources, local governments and other grassroots providers into the care process is a huge effort for Humana within its value-based care markets. Technology, including AI, is helping the company analyze its successes and make better sense of its efforts. Humana even opened a new digital health and analytics branch with a new executive at the helm earlier this year.
After just two months on the job, William Shrank, MD, MSHS, sat down with AI in Healthcare to talk about the changing role of the CMO, the rise of AI in healthcare and how technology is helping Humana shape its integrated care goals as a major Medicare Advantage provider. Shrank replaced Roy Beveridge, MD, who retired this year.
AI in Healthcare: As the new CMO, what’s your broad approach to technology? What is the role of tech for you in your job?
William Shrank: It’s just about how to make the experience better for the members. It’s a maniacal focus on the member and how we can make care more convenient, life more convenient. How do we meet patients where they are?
So, we’re making real investments in digital health, telehealth, investing a lot in our own data analytics, and infrastructure to be able to segment our own population and be more proactive to reach out to members before bad things happen so we can prevent them. The belief is if we’re going to care for patients better in the home, technology is an important part of that. If we’re going to track patients at home, [we have to] create mechanisms for our members to communicate with us, communicate with our care managers to tell us about symptoms or changes. That technology and data is going to be at the core of being able to do that better.
AI in Healthcare: Do you think the role of the CMO has changed as this data-driven strategy has become so crucial?
WS: I think so. The role of the CMO has changed a lot in that it’s a much more population health focused, a more proactive, progressive focus. My sense is there was some time where managed care was more described as a gatekeeper role. Now, managed care is really blurring the line between payer and provider. [We’re] thinking much more holistically about how we are a partner in the management of the health of a member. The focus isn’t how do you say no, it’s how do you advocate for the member and get them what they need.
For me, the CMO role is now generally getting more fun because there are way more tools. You have better data, way more understanding of the membership and what they need, and greater ability to communicate and interact with them. I think it’s an incredibly gratifying role.
AI in Healthcare: How are you thinking about artificial intelligence?
WS: AI is going be really crucial for us because we have so many more feeds of data. We’re getting data from our claims, but also from electronic health records, reports from our case managers, home care providers. There are text notes where we can use natural language processing to try to capture information from.
As you start getting so many more sources of data, you need more tools to be able to learn fast from the data and better understand the population. There are going to be so many more triggers for us to understand risk, to understand where to best intervene. And more importantly, I think we will learn what are the right messages and channels for a specific patient, whether its texting them or calling them or emailing them. We’ll be able to personalize better. This idea of personalized healthcare from an insurance company is novel. It’s really fun. I think with AI we’re still in the early innings, but it’s going to be a huge factor. We came out as making a really big play.
We’re applying a lot of resources in the space, [and] it’s a big part of the future.
AI in Healthcare: How does the new digital health branch interact with your role as CMO?
WS: Really, really closely. Having technology without clear application and a clear sense of what behaviors you want to change and outcomes your trying to produce––it’s the merging of those that are really critical. Our teams are deeply integrated around making sure were identifying the right use cases, investing in the right models. You can make the coolest models in the world, but if they don’t have a clinical application, it’s useless. I don’t think we could be any closer.
For us, it’s really around AI to constantly be assessing the population we serve and continually looking for triggers that signal we need to reach out and be proactive.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."