Humana set itself apart from competitors in a significant way: it became an insurance company that people genuinely appreciate hearing from. 

Throughout its 60-year history, this leading U.S. public health insurer has successfully navigated various disruptions in the industry, from national health crises to the emergence of telehealth. Today, Humana is well into the next phase of its evolution, transforming into a health and wellness company that actively guides individuals towards the healthcare system, rather than pushing them away. 

According to Chris Walker, Associate Vice President of Engagement Marketing, the challenge lies in the industry's complexity and many options. Establishing trust-based relationships at scale becomes the key objective. 

To foster member engagement and build trust, Humana recognized the importance of having the right technical infrastructure and strategic guidance. That's why they chose Salesforce as their solution, uniting teams, partners, and caregivers around a shared view of member data. With a single source of truth for member profiles, interactions have evolved from simple claim processing to providing personalized support throughout each member's wellness journey. 

Walker emphasized the importance of treating individuals as unique entities with their own distinctive healthcare requirements, stating, “Everybody has their own unique journey and healthcare needs.”

Humana's approach focuses on making the path to wellness easier through tailored messaging, services, and care coordination, which enables members to receive the care they need within the comfort of their homes, reducing hospital visits. Notably, this approach has led to faster care delivery and substantial cost savings in information security. 

Now, let's delve into how Walker and his team leverage empathy and connected data with Salesforce Customer 360 to create exceptional care experiences.

1. Initiate proactive communication to encourage members to prioritize their health.

Humana goes beyond mere reminders to visit the doctor when it comes to encouraging people to prioritize their health. Instead, the company proactively offers clinical and emotional support to members who receive life-altering diagnoses like Type 2 diabetes.

Chris Walker, expressing the company's commitment to providing genuine care, says, "I want our customers to feel like they’re cared for as human beings and that we delivered on our brand promise of human care." This means consistently being there for them during significant moments in their healthcare journey.

Humana relies on Marketing Cloud tools for member engagement to fulfill this commitment. For instance, after a Type 2 diabetes diagnosis, members receive helpful email tips on disease management or a list of frequently asked questions about insulin administration. They can also receive text alerts notifying them that a care provider will be contacting them shortly.

Walker emphasizes that It simplifies communication with customers, allowing Humana to engage with them through their preferred channels and deliver relevant content.

In addition to member engagement, Humana uses Marketing Cloud for sales purposes. By customizing 60 distinct prospect journeys, they generate approximately 1,000 leads from interested employers each year. Marketing Cloud Intelligence, powered by Datorama, further enhances sales outcomes by identifying more potential business customers and facilitating personalized messaging.

Humana also employs Marketing Cloud to re-engage inactive group agents, tailoring communications to address their needs. This strategy has proven effective in closing more deals and boosting cross-selling efforts, including automated cross-selling during renewal.

Overall, Humana's proactive and personalized approach, supported by Marketing Cloud Intelligence, ensures that members feel cared for and supported throughout their healthcare journey.

2. Connecting member data.

Humana collects a vast amount of member data, ranging from health records to service interactions. However, managing and leveraging this data effectively can be both challenging and advantageous, particularly when it is stored in different systems.

To overcome this challenge, Humana utilizes MuleSoft's API-led integration capabilities to connect data from legacy systems to Salesforce. This integration enables the creation of a comprehensive and unified view of member data, empowering care teams to deliver exceptional healthcare experiences with remarkable speed—up to four times faster.

As Walker emphasizes, "Data tells each customer's story, and when you bring it all together to create a 360-degree view of the customer, the data becomes incredibly valuable."

For example, if a member undergoes a knee replacement surgery and requires extensive post-operative care, their care team can access a shared view of their complete medical history, relevant lifestyle information, and upcoming appointments. This eliminates the need for the member to provide updates to every clinician individually, allowing them to focus on their recovery without hassle.

According to Brian Cahill, the Vice President and Pharmacy Segment CIO, "Regardless of the diagnosis, we collaborate with the member's doctor to ensure they receive proper treatment and have access to the right support programs."

3. Optimize outcomes through coordinated specialist care based on a 360-degree view of the member.

Humana is driven by a mission to prioritize the patient's well-being and create a healthcare experience that goes beyond industry trends. Their goal is to empower members to lead happier and healthier lives.

When a member receives a serious diagnosis like breast cancer, Humana's care team, consisting of multiple specialists spanning surgery, radiation, and genetic counseling, needs a comprehensive understanding of the member's health data to swiftly devise a tailored plan of action.

To facilitate this, Humana utilizes the Enterprise Clinical Operating Model (ECOM), powered by Health Cloud, which empowers care teams with the flexibility to deliver comprehensive and compassionate care. This integrated platform allows clinicians to access a complete view of each patient's medical history, medications, and lifestyle information while streamlining clinical workflows.

For example, doctors and care teams can easily review a cancer patient's recent lab results, plan the next steps for their care, and coordinate necessary home services all from one centralized interface. Any changes made to the patient's medications by the oncologist are immediately communicated to the pharmacist, at-home caregiver, and behavioral health specialist on the team.

Ensuring the security and privacy of patient data is paramount, and Humana achieves this through Shield, a scalable security solution built on the Salesforce Platform. With data encryption and adherence to best-in-class security measures, Shield protects each member's information on Humana's website, resulting in significant cost savings of $6 million in security-related expenses.

Humana's ultimate objective is to establish itself as a trusted partner for members, providing timely and comprehensive services. By leveraging advanced technology and personalized care, they strive to deliver exceptional healthcare experiences that prioritize the well-being of their members.

4. Provide unmatched convenience through a HIPAA-compliant digital pharmacy.

To provide its members with convenient and hassle-free prescription services, Humana has created CenterWell Pharmacy, its first-ever HIPAA-compliant digital pharmacy built on Commerce Cloud.

This digital pharmacy offers a range of features to enhance the member experience. Members can easily refill prescriptions, track the status of their orders, and even transfer prescriptions to different pharmacies. For example, if a member taking medication for osteoporosis plans to spend the summer in another state, they can conveniently send their prescriptions to a nearby pharmacy within Humana's network. Furthermore, if they have any questions or concerns, they can engage with the pharmacy team through a chatbot.

Humana's primary goal is to ensure that vital medications reach their customers on time, enabling them to achieve optimal health. To meet the stringent HIPAA standards and maintain the utmost security, Humana employs Shield, a comprehensive security solution. Shield employs robust encryption to safeguard sensitive health data and restricts access to authorized users only. This empowers members to confidently utilize the CenterWell Pharmacy, knowing that their personal information is protected and managed by trusted professionals.

5. Transform the healthcare business with strategic guidance throughout the entire journey.

To evolve from an insurance provider to a trusted healthcare partner, it takes more than just choosing the right technologies. It requires the guidance of strategic experts who are dedicated to bringing your vision to life.

That's why Humana turned to Salesforce Professional Services for its implementation oversight and expertise in best practices. With their support, Humana can build long-term success and extract maximum value from its Salesforce ecosystem. By aligning on a shared vision, the team of experts designed a solution that accelerates progress, ensures a smooth transition to Health Cloud, and enables the launch of Humana's first-ever HIPAA-compliant digital pharmacy on Commerce Cloud.

"We have found Salesforce Professional Services to be an excellent partner on this journey, helping us optimize our investment and quickly realize its value," said Walker.

Given the critical nature of Humana's operations, even a few minutes of downtime can have a significant impact. To minimize disruptions, Humana relies on the Signature Success Plan provided by Salesforce. This plan continuously monitors performance, detects errors, and keeps track of platform limits. By proactively identifying potential risks before they affect system performance, Humana stays informed and prepared. Additionally, the Signature team offers proactive, personalized expertise to help Humana reduce technical debt, accelerate innovation, and mitigate security risks.

With the support of Salesforce Professional Services and the Signature Success Plan, Humana can confidently deliver highly personalized member experiences at scale, ensuring that its customers receive exceptional care and value from their partnership.

Source: Salesforce's Website