Billion a year in wasted spending on health care. He man is the secondbiggest provider of the Medicare Health plan. From the city club of cleveland this is about one hour. Good afternoon. Welcome to the city club of cleveland. I and the president of the board of directors. I am delighted to introduce bruce broussard, the president and ceo of humana, at a fortune 100 insurance provider and administrators serving over 11 million customers. Over the past four years, the issue of health care has been at the center of our nations great policy debates with implications beyond the Healthcare Industry impacting our larger fiscal policy and important social concerns. We are fortunate to have mr. Bruce broussard to discuss this policy. Prior to joining humana in 2011 he was an executive with a corporation and the u. S. Oncology. Large producers and providers of healthcare products. With that background, he brings to our podium a Broad Perspective on the Health Care Issues facing our country. He told his undergraduate degree from texas a m and day mba from the university of houston. Looking forward to your discussion on this topic. Thank you. Thank you. Thank you appear. I appreciate the opportunity. Our nation is wrestling with one of the largest issues in a long time, our debt. And the large amount of debt the United States is facing. I will outline the challenge we face and some transforming healthcare ways we can solve the issue. I will demonstrate how new approaches other integrating a Delivery System and how it is already achieving outside the federal government. I will describe how health care can harness some plausibility to have sustainability even as it undergoes some transformation. I want to talk about ohio. They are addressing some of these large issues here recently. The recently announced demonstration of instigating Care Coverage for the dual eligible. The dough eligible are individuals who can be covered by medicare and medicaid. It represents 20 of the medicare population but 31 of the cost. We are excited to be part of this program with a company in de 10 called care source. We will be serving minutes this our partnership prepares our ability and also the managing complicating conditions and their experience of being the leader to search to underprivileged people and health care for the last 23 years. It is this type of partnership designed to integrate care, simplify the experience for the elderly and disabled individuals. We have a strong commitment to ohio as it is one of the sixth largest state of the medicare population. Our commitment is to improve the health and lifelong wellbeing of our members through a comprehensive program of preventive care, coordination, and care of chronic conditions. Another way we are demonstrating our health care is to help them lead a more active life. We know the rate of health care is not a Healthy Lifestyle most americans. We are battling this issue on great many friends. The most exciting are here in cleveland. Eight weeks ago we join forces with the metropolitan Housing Authority to build a multi generational playgrounds just a few minutes east of here. 150 volunteers from humana and the committee teamed up a place to build a place where children and seniors can play. I am equally proud to tell you we are one of the client sponsors of the games that will actually take place here in cleveland. Games are inspirational. It is a perfect example of health and wellbeing among seniors. I encourage each one of you to get involved in the games and at least make the claims to visit as a spectator. The work we do has a cloud hanging over us. That cloud is our National Debt crisis. The u. S. In National Debt stands at more than 11 trillion and could double in 1 decades. If you add the money that the from trustowed funds, our debt exceeds 16 trillion. Let me place that in context. Increasing by the minute by 2 million. Humana strongly believes that if we did not address the issues our economy will suffer. We must come together to fix it with a need a comprehensive bipartisan plans that address is revenue including progrowth tax reform, spending, and entitlements. He man is involved in campaign to fix the debt. We believe the campaign will make a difference in pushing Congress Responds relate to enact a comprehensive deal. I encourage each one of you to get involved and fix the debts fixthedebt. Org. Healthcare plays a significant role in our nation spending. Controlling healthcare costs is linked directly to our fiscal security. We are dispensed 16 of our gdp in in u. S. In health care. We have a lower life expectancy, higher in thin mortality. Were much more obese. We over use of medical services. The u. S. Has 26. 6 mris for every 1 million population pure that compares to 6. 8 units for developing countries. Prevalence is increasing. 75 of our Health Care Dollars today is spent on chronic conditions which many are preventable. The cost of care varies hugely from hospital to hospital and doctor to doctor. Waste and fraud cost the nation 750 billion a year. We wonder about the impact of the 2010 Affordable Health care act. Also known as health care reform. Many major provisions are scheduled to take effect in 2014, a little more than a year from now. It demonstrates projects designed to improve the Delivery System. It also opens access to individuals. It does little to address the major problem in health care. That is costs are rising. They are too high. In reality they are unsustainably rising too fast. Something must be done. We must address the sustainability across the entire system. Privatesector is playing a key role in leading in changing our reform. I want to talk about the way to simplify health care as a means of putting it to a sustainable level. If you look at health care from the point of view of the average person, the system is unbelievably complex and fragmented. Decisions often involve many choices and overwhelming information. Health care bills and statements are keen in their complexity. Even finding the right facility may be fraught with guesswork and uncertainty. We must applaud our approach to the health care. We must simplify our approach to the health care. A simple comprehensive actionable read you of the system is the key. We are one of the only ones that have this review. We provide oversight to the customer at their actuarial through actuarial science. Our goal is to create a model driven by primary care providers that uses a shared data at the point of care to improve outcomes, lowercost, and creating a Better Healthcare experience. Our motto integrates our delivery. In many ways our model is an evolution with its roots prevalent 20 or 30 years ago. Today simplicity is the key. We believe in the model that emphasizes primary care. The concept relies on primary care physicians to coordinate care for patients, helping them navigate the Healthcare System so that they can receive the right care at the right place at the right time. Like many organizations, technology plays such an Important Role in enabling this happened. We support physicians and patients with accelerated information. Our system uses sophisticated models to identify individuals where these events occur. In a month it identifies more than 400,000 members. It produces over 800,000 messages. This stands at 34 . Leading to Higher Quality and lower costs. It enables practice management, including health records. This allows to share patient information. We also support Health Care Members with an array and Service Programs designed to maintain health and address chronic conditions. We leave members their help through a health assessment. We have a portal that rewards the member for following a customized exercise and life style plan. We are borrowing from other industries to create an experience like the frequent flier program. The more they engage in healthy behavior is the more they will be rewarded from get cards to merchandise. A peer review study shows it works. It reduces hospital costs by more than 7 . And 15 for participants with cancer. Four members of that need ongoing care, our program for senior members with chronic conditions is another good example. It identifies individuals before it occurs. It unites acute and chronic management before the early identification of absent care. It develops healthcare goals in supports. It is designed to help seniors. When people connect with humana care is a good things happen. Emergency room visits have decrease by 13 zoom in readmission rates have reduced by 21 . Wellbeing for us is centered on line time worked in fiscal help. It embraces financial personal security. Producing lower costs, better outcomes, and better member experiences. Our most extensive experience with this model comes from our Medicare Advantage population. Unlike original medicare which rights checks, it shows an integrated care. The empirical evidence shows that the Medicare Advantage plans to deliver Higher Quality of care at a lower cost. And higher percentage receives better coverage. They say 31 million a year in the first year. Results like this only happens because of close coordination, cooperation, in collaboration between the various participants there is a strong provider component and a commitment to sustainable delivery. Doctors and hospitals must commit to practicing evidence space medicine. They need to wire themselves into a comprehensive Electronic Network that includes other providers and payers like us. News coverage focuses on health care reform, the private sector is accelerating the adoption of a Delivery System and already makes a difference. Out of control healthcare costs are the problem. The solution is care that combines data, technology, and simple customer friendly and all the programs. Results would be better quality, better outcomes, lower cost and Better Health care experiences. Thank you. I will open it up for questions. We are honored today to welcome bruce broussard. Well return to our speaker momentarily for traditional questions. Please formulate your questions now and remember to be brief and to the point. We welcome all of you here and those listening to 90. 3. Wtam or one of the many ready is stations across the country. A Television Broadcast partner is on the idea stream. Television broadcasts are made possible by Cleveland State university. Our web cast is supported by the university akron. Closed captioned as a possible. Next friday the city club welcomes aaron david miller, Vice President of new initiatives and distinguished scholar of the Woodrow Wilson opportunity. Visit our web site for information about our upcoming forums or to listen to a pot cast podcast of our past programs. Thank you for your support. We will like to welcome todays Program Students toward joining us from area high schools. Student participation is made possible by generous gift of the charitable trust. We welcome students from the high school. Tand and be recognized will you stand in the recognize . [applause] you like to turn to our speaker. Now we would like to turn to our speaker. We have our first question. You talked about the complexities facing the average american patient and certainly our complex exchange will not make it more complex. I noticed that humana played a part in the drafting of the Affordable Care act. My question is why did not humana tried to copy the system which is very simple in canada and other parts of europe on having a single pair take care of all medical expenses . Good question. We could be here quite some time to answer it. The system that works in canada is still expensive. It is not have the care level that is here in the United States from the standpoint of technology. Even in the European Countries they have a one payer system. What has happened is that the one pear system has caused a lot of lines, health care is delayed to getting to people. As a result there is a private sector performed here. We are a big believer in integration of care in sioux a simpler model into a simpler model where its is under one roof or in a society that can access care at a single point and be able to use these across the platform as a whole. With not a big believer the government will sponsor a only plan. It is not encourage innovation or competitive aspects. We think it only make us better going forward. Being a texas a m guy, what you make of johnny and kenny . [laughter] the school is making me proud. The years ive been associated with texas a m ive never seen a better football team. I think he will win. That is off topic. I want to give you some background for. I am a humana Medicare Advantage subscriber for my wifes retirement. Satisfiedlly very with the program and particularly enjoyed the silver sneakers partnership. I was pleased to mention the senior games here. My questions are multiple. Medicare advantage plants have a fair amount of criticism during the discussion of the Affordable Care act as being more expensive and not performing at the level they should have. Corbat be main he maintained years are doing well. I would like to know the Broad Spectrum rather than just what humana is doing. The other piece that goes with this goes from the saving of money to help fund the Affordable Care act. How is this going to affect things . The third part of a question is is there a significant broadbased data to show that change in lifestyle has changed the cost curve downward . Not just years. I am looking at what is the total population. My memory is a little bad. I can do one are two questions but when you get to three is more complex. You are exactly right. The one complaint with medicare and vantage early on was that it was costing the federal government more than traditional medicare. It was not a round the effectiveness of the plan. It was really around the rates they were paying. They were paying above the medicare reads. They are getting around stimulating that. It relates to your second question. Now they are beginning to move these rates. To fundnow using that other resources. In some of the regions, now theyre actually below medicare rates. We now offer services. This motivates us as an organization to be more innovative in insuring people are healthier and being treated better. We get paid a fixed payments. The duty is that we have a seven are tinea relationship. We want you to be healthy. We want you to be in the right areas. If youre healthy we do better. All of our interests are lines in that regard. As our rates come down to become more innovative. This is the future of health care. The components around quality in managing care and being able to help individuals navigate the system continue to continue at the right time. The last question was around healthy behavior. Being healthy is not only the right of view from abridging the right thing to do from a health point of view it is not only help the from the standpoint of prolonging some kind of chronic condition. Usually 23 usually have two or three chronic condition. One leads to another which leads to another. Living a Healthy Lifestyle helps prevent that from happening. It helps you will be more engaged. You see our dream of lifelong wellbeing is not only the healthl help but the but the mental. Diabetes is a great experience. One of the most six offensive ones we face today. Some of this is hereditary. A lot is what we do to our body. He spoke about the unneeded use of medical services and irrational spending. Do you believe that is due to a fall in the Healthcare System . There is a flop. There are two aspects that really has gotten us to where we are. One is the fragmented nature. Their only caring about their own. The second aspect is we pay for what we do. An individual that owns and imaging device. The outcome is a healthy person. What needs to happen is moving payments to not what youd do but if it is the effect of what you have. When i talk about medicare we are not motivated to do more mris we are trying to get him to help more effectively. We are trying to piece will individual services as opposed to paying for the outcome piecemeal individual services as opposed to paying for the outcome alone. How about a silo of the young people . With the Affordable Care acted do you think there is an understanding among that generation of all the implications for them, including costs . No, i really do not. The affordable pair Affordable Care act will raise the cost of insurance for younger people. There is an aspect that they have to take everybody. There is an aspect that you can only charge the difference between the lowest charge you have for individual and the highest. Help the people, their costs are going to go up. In addition what you have is a lot of fun help the people that were uninsured coming back into the marketplace. This will cause the rate to go up in that regard. The healthier, a younger people will pay more. One of the most compelling point of your discussion with your reliance on primary care physicians. Unfortunately, at the stats that i read say that we do not have enough now and there are even fewer in the pipeline. What is humana going to do about then . That . We will love for the federal government and industry to help stimulate more individuals to come into the primary care profession. That is one. We have activities in that context. Similar to other industries, how do we get them more productive deck .