From left to right, Mark Kent, President and CEO of CAC-Florida Medical Centers; Dr. Sonia Michael; Bruce Broussard, Humana President and CEO, and Dr. Andres Restrepo at the CAC-Florida Medical Center in Miami.

Simple, caring, coordinated and convenient. Those are not words typically associated with our nation’s complex and fragmented health-care system, but they are often used to describe CAC-Florida Medical Centers.

The 15 medical centers, all in South and Central Florida, primarily serve Medicare and Medicaid members who will find a broad range of medical services, from primary care to specialty care, as well as dental, vision and pharmacy.

“CAC-Florida Medical Centers are a perfect example of where we see health care moving – to an integrated health delivery model as opposed to treating sickness,” Humana President and CEO Bruce Broussard said during a recent visit to Miami’s CAC Medical Center, which is a subsidiary of Humana. “We want a holistic relationship with our members.”

Dr. Sonia Michael, CAC’s Chief Medical Officer, has seen firsthand how effective the holistic approach can be.

“One of the unique aspects of CAC is the approach we take when treating our patients, who are predominantly seniors,” said Dr. Michael. “We take a step back and look at all aspects of a patient’s life – medical, social, economic and emotional. It’s easy to write a prescription for a patient who has diabetes, but does he or she have the resources to get the food that they need to live a healthier life or can we direct them to community agencies to help with those issues? Are they struggling with depression? It’s not simply about helping them temporarily … it’s about maintaining wellness. We work together on the long-term functionality of our patients and their quality of life.”

Mark Kent, President and CEO of CAC-Florida Medical Centers, is proud of the fact that the centers’ “outstanding level of coordinated service” to seniors and underserved low-income communities has created a model being replicated across the U.S. The centers’ achievements are being recognized by others as well. Last fall, CAC-Florida Medical Centers achieved NCQA Patient-Centered Medical Home Certification because of its long-time commitment to high-quality primary and preventive patient care. Under the Patient-Centered Medical Home concept, primary care doctors coordinate all patient care with a team of providers, who systematically track tests and results to better identify patients at risk, and who provide prompt access to care and follow up after visits.

“By doing all of this, over a two-year period, we’ve reduced unnecessary emergency room visits by 57 percent and in-patient admissions by 42 percent across patients in our diabetes program,” Kent said. “The medical home concept, with a focus on primary and preventive care, has always been at the heart of our approach to quality patient care. We’re proud that our medical centers and our primary care physicians have achieved rigorous standards that physician practices must meet in order to attain this significant accomplishment.”

One of the most important services the centers provide is taking the complexity out of the health care system, said Bert Valdes, Chief Operations Officer at CAC-Florida Medical Centers, which Humana acquired in 2005.

“We are unique because we incorporate a multidisciplinary approach that allows seniors to rely on a single organization to manage the whole gamut of care, from routine to complex,” said Valdes. “And it goes beyond the medical needs. Our Wellness and Activities Centers provide an opportunity for CarePlus Health Plans members who may be alone and depressed to interact with people who have similar conditions and develop a support system, a social outlet.”

Valdes said the medical centers have a genuine culture of caring that has been built through many years of providing services to Florida communities.

“We have tremendous tenure among our associates,” he said. “We’ve grown with the communities we serve. In many cases, our associates have known a patient for 15 to 20 years and sometimes their parents or grandparents are patients.”

Valdes said that his best example of the value that the centers offer patients is based on the experience of a senior in his own family who lived alone and showed signs of anxiety and depression as she dealt with diabetes treatment. But he saw positive health and behavior change after she began attending lectures and exercise classes at the Wellness and Activities Center.

“She was persuaded to attend one educational health lecture at the center, then began attending more and more until it became a daily routine,” he said. “In the space of six months, we no longer received calls related to anxiety and other concerns. She developed a support network and even goes grocery shopping with people she met there. It changed her life, and she is a totally different person.”

Through its long-time commitment of providing coordinated, quality care, CAC-Florida Medical Centers are becoming a model for the future of health care.

Fast facts about CAC-Florida Medical Centers:

• 15 multi-specialty medical centers located in South and Central Florida.
• Achieved certification by the National Committee for Quality Assurance (NCQA) as a level one Physician Practice Connections Patient-Centered Medical Home.
• Diabetes Recognition Program developed by the NCQA and American Diabetes Association recognized CAC-Florida Medical Centers physicians for providing excellent diabetes care
• Staffed by more than 100 primary care physicians and specialists.
• 130 vans provide free transportation for all CarePlus Health Plans members.
• 13 Wellness & Activities Centers that offer educational programs and group activities that focus on healthy aging, socialization and lifestyle enrichment and wellness.
• CAC-Florida Medical Centers opened its doors to Miami-Dade County’s Hispanic population in 1964 under the name Clínica Asociación Cubana.
•  Acquired by Humana in 2005.
•  Most of the 15 centers offer these services in a single location: primary care, preventive care, cardiology, chiropractic, dermatology, endocrinology, gastroenterology, general surgery, gynecology, neurology, ophthalmology, optometry, orthopedic surgery, podiatry, urology, pharmacies, dental offices, and ancillary services (X-rays, ultrasound).

Lynece Hand is passionate about helping improve health and reduce hospitalizations, but she also treasures the relationships she develops through her work with the Humana Chronic Care Program.

Navigating our nation’s complex, costly and fragmented healthcare system can be a daunting task for even a healthy person dealing with a temporary minor illness. Imagine how dizzying and hopeless it can seem for those who live with chronic conditions such as diabetes, congestive heart failure or coronary artery disease. How do they cope with multiple doctor visits and medications, transportation issues, potential job loss and, in some cases, living alone?

The national Humana Cares/SeniorBridge Chronic Care Program is helping ease the burden for more than 225,000 chronically ill Humana members by providing personalized, integrated care management services that reduce hospitalizations, readmissions and costs while improving their quality of life.

“Humana Cares/Senior Bridge is such an important part of Humana and our integrated care delivery model,” Humana President and CEO Bruce Broussard told members of the Humana Chronic Care Program team during a recent visit to the national care center in St. Petersburg, FL. “It’s the pride of the company.”

“It’s a perfect illustration of how an integrated approach to lifelong well-being can improve outcomes, lower costs and create a better, simplified healthcare experience,” Broussard added.

Making connections, making a difference
Lynece Hand, a registered nurse, has seen firsthand the positive, empowering effects the Chronic Care Program can have on those with chronic conditions.

“We help educate our members about managing chronic disease; encourage and remind them to get preventive screenings; set goals for improving health; and, with frequent contact, learn what their greatest health concerns are, what motivates them,” Hand said. “We can then guide them to develop and reach goals that bring a better quality – and quantity – of life.”

While talking to a member in Texas, she learned that he was struggling with chronic insomnia and had been unable to work for eight years. Hand reviewed the medications he was taking and discovered that insomnia was a possible side effect of one of them. She discussed the issue with the member’s doctor, who instructed his patient to take the medication at a different time of day. The member no longer has insomnia, has returned to work as a substitute teacher and is working on his teaching certificate.

The Humana Chronic Care Program goes beyond medical considerations, and looks at the whole person and areas of concern that could adversely affect physical or mental health, whether it is financial, social or legal issues. Hand is passionate about helping improve health and reduce hospitalizations, but she also treasures the relationships she develops through her work.

“While talking about a medical issue, such as diabetes, members may identify something else that is going on – whether it is a family issue or a recent death –  that may be affecting their health,” said Hand. In addition to helping the member in Texas with his own health, Hand resolved a concern he had with his son’s health. The previously healthy young man who enjoyed a full life suddenly suffered extreme fatigue, weight loss, several hospitalizations and could no longer work. Hand knew the family enjoyed hunting, and with a little investigation, was able to pinpoint the source of the son’s problem. He had contracted an infectious disease through contact with an animal during a hunting trip. A simple treatment with antibiotics solved the issue, and the son is once again healthy and enjoying life to the fullest.

How it works: Coordinate, connect, simplify
Members who are eligible for the Humana Chronic Care Program are proactively chosen using a predictive model to identify those who have chronic conditions that are the most difficult to manage and may require the most assistance. Once a member is enrolled in the program, an assessment is made to identify the types of services that may be needed: health education and coaching, regular telephonic contact or home visits, medication education, physician care coordination, end-of-life planning, depression screening, post-hospital discharge support, in-home safety assessments, remote home health monitoring, meal and transportation assistance or caregiver training and support.

To meet these needs, the multi-disciplinary Humana Chronic Care Program team, which is one phone call away for members, includes social workers, community health educators, registered nurses and other healthcare workers.

Debra Kleesattel, Director of Operations for Humana Cares/SeniorBridge, has been with Humana Cares, headquartered in St. Petersburg, FL., for several years and has witnessed enormous growth and an expanding national footprint and capabilities with the 2012 acquisition of SeniorBridge.

The Humana Cares/SeniorBridge program helps Medicare Advantage members age at home, the chronically ill stay out of hospitals and all of them navigate a disjointed and confusing system, said Kleesattel, who has a PhD in gerontology.

“We bring all the parts and pieces that don’t seem to fit and put them all together for the individual,” she said. “We look at all areas of life. A caregiver may have diabetes and neglect his own needs because of the demands of being a caregiver to his wife who has Alzheimer’s. We connect the caregiver with a local area agency that can provide a break, change his perspective and improve his own health. Or maybe it’s a financial issue, such as someone who needs a wheelchair ramp but can’t afford it. We connect them to the resources they need, which enables them to focus on better health decisions that keep them out of the hospital.”

“We make sure they know that we walk beside them and are here when they need us,” Kleesattel said.

By the numbers

• To date, Humana Cares/SeniorBridge members have experienced a 26 percent decline in inpatient admissions; and 18 percent drop in hospital readmissions; and 10 percent reduction in emergency room visits.
• Personalized, telephonic care management, health coaching, health education and health support provided by registered nurses and other health professionals across all 50 states.
• Community-based, in-home assessments and care management by nurses, social workers or community health educators in 32 states and Washington, D.C.

Aida Darnell, center with orange balloon, participated in a Silver Sneakers Fitness Program demonstration during the Guidance Center grand opening in Louisville, Ky. She said she would defiinitely return to check out other activities.

Humana is celebrating the opening of its 24th Guidance Center, the first to be located in Louisville, Ky., and the reopening of its first Guidance Center in Zephyrhills, Fla.

The Oct. 18 grand-opening festivities in Louisville drew a crowd of area residents interested in learning more about the free services, classes, and social activities now offered to the community.

The Louisville Guidance Center, 1918 Hikes Lane, will be open Monday-Friday from 9 a.m. -5 p.m. In addition to personal, face-to-face service, a variety of activities will be offered each week, including seminars led by local experts, video game bowling tournaments, dance lessons, movies, and board games.

Humana’s Guidance Centers* , which are located in 23 cities around the country, provide assistance with questions about health insurance claims and benefits, and help individuals locate doctors, dentists and pharmacists. But the centers, which are open to anyone in the community – not just Humana members – also provide opportunities for people to live healthier, happier lives. Those who regularly participate in activities at the centers say they feel revitalized and have experienced a renewed sense of purpose and belonging.

Humana opened its first Guidance Center in 1997 in Zephyhills, Fla. On Oct. 17, Humana reopened its original center in a new, larger retail center just north of Tampa. The gala event celebrating this new space attracted several hundred residents, community leaders and local leaders. The new center encompasses nearly 5,000 square feet with a community room, W-Fi, offices and a full-time bilingual Humana customer service representative.

Related articles and videos

• Humana Guidance Centers: Making a difference
• Taking the First Step to Better Health

* The Guidance Center classes and activities vary by location, and some are offered only to Humana members. Please check with your local Guidance Center to verify the availability of activities and classes.

Volunteers celebrate during the ribbon-cutting ceremony at the Gateway Park Apartments in Portland, Oregon.

More than 250 volunteers joined forces to build a multigenerational playground in six hours in Portland, Ore., on Sept. 22 as Humana and KaBOOM! kicked off their second annual fall playground tour in which they will build nine playgrounds in nine cities over the next nine weeks.

Residents of Gateway Park Apartments in northeast Portland had met weeks before to provide input and help design their new 1,710-square-foot playground, which features fitness stations, traditional kid-friendly equipment, walking paths and adult/senior stretch stations.

The playground will give children in this apartment community –who had been playing in a parking lot –a safe space to play. It also gives adults in the apartments a place to exercise.

The Portland playground is now included on a growing list of play spaces that Humana and KaBOOM! are building across the county. The playgrounds promote healthy play for people of all ages, but they also help families reconnect and create memories. Enthusiasm for these neighborhood legacies continues long after the day of the build.

“My family and I have continued to use this playground week after week since it was built last fall,” said Dorothy Jackson, of Midway, Fla., who frequents a playground Humana and KaBOOM! built last fall in Orlando, Fla. “The equipment has given me a reason to stay active and a safe place to play with my grandchildren—I love it!”

In addition to Portland, playgrounds will be built in Milwaukee, Wis.; Cleveland, Ohio; Des Moines, Iowa; South Charleston, W.Va.; Springfield, Mo.; Huntsville, Ala.; Baton Rouge, La., and Phoenix, Ariz. from Sept. 22 through Nov. 17.

Based in part on the success of their 2011 campaign—building eight playgrounds in eight cities in eight weeks—Humana and The Humana Foundation recently entered into a three-year alliance with KaBOOM!, running from 2012 through 2014. As part of the alliance, Humana, The Humana Foundation and KaBOOM! are now teaming up to build more than 50 playgrounds across the United States over a four-year time frame.

Additionally, The Humana Foundation is also sponsoring the KaBOOM! Playful City USA initiative, a program honoring cities and towns that make play a priority and use innovative approaches to get children active, playing, and healthy.

Related Videos and Articles

• In this video, the residents of the desert community of Thermal, Calif., who named their playground Mirage, explain what it means to them and how it helps build hope for healthier, happier days ahead.
• “Humana leaves a legacy in Charlotte, Tampa”: Humana and KaBOOM! built multigenerational playgrounds in the two host cities for the 2012 political conventions.
• This AARP blog, “The Shape of Things to Come: Adult Playground,” discusses the many benefits of the multigenerational playgrounds.

Humana Chairman and CEO Mike McCallister joined more than 140 associates who volunteered to build an innovative, multigenerational playground in the city of Lauderhill, Florida. Humana volunteers built the 2,500-square-foot playground at Ruth Rothkopf Park, as well as five standalone exercise stations for adults and senior citizens. In addition, volunteers also built new picnic tables, benches, shade areas, and an enhanced walking path. Humana continues to celebrate its 50th Anniversary. Fifty years of helping people. The playground build is part of a continuing effort to say thank you to the communities where our members live.