The president says his 750 billion of waste and help you annually. Bruce broussard recently spoke to the club of cleveland about health care, insurance and medicare. This is an hour. [inaudible conversations] of doctrine and welcome to the city club of cleveland. Thank you it shall come the president of city club is. I am delighted to introduce to you today, so when can president effective january 1, ceo of separate ink, and managed health care and insurance provider and administrators serving over 11 million customers in the United States. Over the past four years and into the recent election, the issue of health care has been at the center of our nations great policy debate and implications beyond the Health Care Industry impacting our larger fiscal policy and important social concerns. We are fortunate to have a test today mr. Broussard insights on the industry in developing policy. Prior to joining humana 2011, mr. Broussard, u. S. Oncology. Large producers and providers of Health Care Products to Major Health Care institutions. That background, mr. Brousard brings a Broad Perspective on Health Care Issues facing our country. Mr. Broussard holds his undergraduate degree from texas a m and an mba from the university of houston. Were very much looking forward to your comments today. Thanks for being here. [applause] thank you. Well, thank you. I really appreciate the opportunity from each one of you. Our nation is actually wrestling [inaudible] a large amount of debt the United States is facing. I will outline the challenge we face. Ill also show you some transforming health care is one of the ways we can solve that issue. Ill demonstrate how new approaches to integrating the Delivery System and how it is already achieving some result outside of the federal government. The health care can harness simplicity, has sustainability, even if the Health Care System undergoes some significant transformations. First, but to take a moment and talk about ohio and cleveland and how theyre addressing some of these large issues here locally. Particularly a recently announced demonstration of integrating care for coverage for the dual eligible. The dual eligible or individuals covered by medicare and medicaid. I dont know if you know this, but dual eligible operation represents 20 of the medicare population today and 31 of the cost. With excited to be part of this program under the Strategic Partnership with the company in dayton called care stories will be serving beneficiaries in cleveland and akron and youngstown. Our partnership with care stories our ability and also appliqued conditions and their experiences being the leader in serving underprivileged people in health care for the last 23 years. It is this type of partnership designed to integrate care and simplify the Health Care Experience for elderly and disabled individuals doubletalk about in a few moments. Their strong commitment to ohio as it is one of the sixthlargest states for the medicare population. Our commitment to this is to improve the health, life will be in the comprehensive program of preventative care, care coordination for chronic conditions in the companywide dedication to experience and customer service. In the health care and wellbeing is our extensive work to help people with lifestyles of the demaret device. We know the root of the countrys problem is unHealthy Lifestyles. In humana we are battling this issue in two of the most exciting of them are here in cleveland. Eight weeks ago we joined forces with the metropolitan Housing Authority to build a new multigenerational playground just a few minutes east of here. 150 volunteers from humana the community teamed up to build a place where kids and adults serve. One of 25 and 2011 built across the country as we plan to do many more over the coming years. Im equally proud to tell you where one of the Plan Sponsors of the National Senior games that will take place in cleveland in july 2012. The senior games are inspirational and a perfect example of health and wellbeing as a Business Leader come in being part of this for many years, i encourage each one of you to get involved in the games or at least make a point to visit. However, right now the work we do, the work each one of you do have a cloud hanging over it. The cloud is our National Debt crisis. As you likely know, the u. S. National debt stands at more than 11 trillion that could double in one decade. In addition if you had demanded the government owes from trust funds, art that exceed 16 trillion at a place that in some context is increasing by the minute the 2 million. Humana strongly believes if we do not address our debt issue, our nations economy will suffer in the fiscal crisis. They must come together as a nation to fix the definitive comprehensive bipartisan plans, including progrowth action reform, spending and entitlement. Humana is involved in campaign to fix the dead from the bread bowls and simpson and that was a group of state and policy leaders. We believe the campaign will make a difference in pushing congress smartly and responsibly to the comprehensive deal. And i encourage each one of you to get involved to fix the debt. Org. If you take any information not presented to talk to you about it. In the meantime, recognize health care plays a significant role in our nations spending. Controlling Health Care Costs is linked directly to our fiscal security. We are to spend 16 our gdp in the u. S. For this we have lower life expectancy. With higher infant mortality than many developed nations. We are much more obese. We overuse medical services. Much more the u. S. Has 26. 6 mris [inaudible] that compares to 6. 8 unit. Chronic illnesses prevalent and is rapidly increasing. 75 of our Health Care Dollars is spent on chronic conditions. The cost of care dairies usually and rationally from hospital to hospital and doctor to doctor. Worst of all, waste and fraud in duplication of medical services across the nations 750 billion a year. You also wonder about the impact of the 2010 Affordable Care act, also known as Health Care Reform. Many major provisions are scheduled to take effect in 2014, just a little more than a year from now. The industries projects designed to improve the Delivery System, but also opens access to cover millions more individuals. Still, theres little to address on the major problems and help care for knots cost of rights are too high. Clearly something must be done to stabilize the program like medicare, but also to address sustainability across an entire Health Care System. Played a role bleeding and changing our reform. What i want to talk about today is a way to simplify health care is a means of putting a sustainable level. If you look at health care from the point of view of the average person, the system is unbelievably complex. Health care decisions often involve many choices and an overwhelming amount of information. Health care bills and statements even finding the right specialist for a facility for the guesswork. We must simplify or purged the health care, attacked the raising costs and other issues for the ordinary americans to understand and act upon. In order to create Sustainable Health care Delivery System. A simple, comprehensive actionable view [inaudible] of health insurers, we are the only ones who have such a view. Our old rule was to provide oversight for the cut of her direction uriel signs. Our new role is to create an integrated delivery model driven by primary care providers to users share data to improve outcomes from the lower cost. As marina humana, our model ints the pharmaceutical solution and productivity platforms. In many ways, our motto is an evolution of historys prevalent 20 or 30 years ago. Todays simplicity is the key. We believe an integrated delivery model that emphasizes primary care can provide outcome over the cost of care, especially to patients with critical or complex medical needs, including patients in the medicare and medicaid. The concept relies on primary care physicians to coordinate care for patients helping them navigate the Health Care System. They can receive the right care at the right place at the right time. Like Many Organizations and industry, technology play such an Important Role in enabling us to have been. Investing today in Data Analytics capabilities that identify care and support positions of patience and relevant information. One example [inaudible] to identify individuals before it occurs. In a month, identifies more than 407 numbers and produces over 800,000 workers. Conversion rates for these interactions been a member got the message in the gap in care was closed. Leading to Higher Quality at lower cost. Our vision includes technology that enables Practice Management , practices that use different Electronic Health records to Exchange Information and talk to each other. This allows physicians to share patient information in realtime to further reduce the gap care. We also support Health Plan Members with an array of service and programs designed for making health and addressing chronic position. For members to assessment [inaudible] dc10 to the humana vitality, personalized portal that rewards the number for following a customized exercise and diet and lifestyle plan. Essentially we are borrowing from other industries to create an experience. The more members engage in healthy behavior, the more they will be rewarded, ranging to give kurds. The peer review study of recipients show of works. Reducing hospital cost them within 7 cardiovascular disease [inaudible] for members and a frequent and ongoing clinical care, our humana care Program Senior members are an example. The sophisticated predictive models i discuss identify individuals. The humana care uniting a cute and chronic management of the early identification. Humana care develops individuals, selfcare goals of behavior through proven techniques, including home visits designed to help seniors age with grace. When people connect with humana care, good things happen. Data show the hospitals reduce 32 . Emergency room visits reduced by 13 and reignition reduced by 26 . Humana carries the window that would help people achieve lifelong wellbeing. The wellbeing is for us centered on onetime work. It also embraces financial and personal security, social and Community Belonging and vocational purpose. Producing lower costs and better quality, better outcomes. Our most extensive experience with this holistic integrated model comes from our medicare population. Seniors and disabled individuals. Unlike original medicare, and merely writes peer services, Medicare Advantage incorporates integrated systems of care like humanas model. Empirical evidence shows humanas fan delivers Higher Quality of care at lower cost than the original medicare. Advantage members receive Preventive Services any difference of 7. 3 and original medicare. Set three Advantage Care members received nearly 15 less than the original medicare was no reduction in quality. This requirement system would save 31 million a year. Results like this does not happen that only happens because of close coronation, cooperation and collaboration. As i mentioned earlier, theres a strong provider component and commitment to sustainable delivery. Dark or some hospitals absolutely must remain. They also need to wire themselves into a comprehensive Electronic Network that includes other providers and payers like us. While the News Coverage focuses on Health Care Reform, the air, including both providers is accelerating the adoption of a Delivery System for verity makes a difference. In summary, outofcontrol Health Care Costs are a problem. The solution is an integrated care that combines data, technology and simple customer friendly pulpy programs. Results will be better quality, better outcome, lower cost and better Health Care Experience. Thank you. I think well open it up to questions. [applause] we are honored today to welcome bruce brousard, president of humana inc. Well return to her momentarily for the traditional city club questions. Please summit your questions now and remember to be brief and to the point. We welcome all of you here and those listening to 90. 3 coming tv cov covered the vtam for many radio stations across the Country Television broadcast partner. Television broadcast were made possible at Cleveland State university. I like what cast is supported. Closed caption of our program made possible. Next friday, december 7th, city club welcomed aaron david miller, Vice President of new initiatives and distinguished scholar at the Woodrow Wilson international center. Friday december 14 city club will host dan cronin, president of the io of the National Association and homelessness. These visit our website, city club. Org for information about her upcoming foreign or to listen to a podcast of past programs. Wed like to welcome our guests at tables hosted by humana. And medical mutual. Thank you for your support. Would also like to welcome to todays Program Students who are joining us from the area high schools. Student participation is made possible by generous gift from a Charitable Trust her today we welcome students from jcpenney school. Students, please stand and be reckoned as. [applause] now we would like to return to her speaker for a traditional city club question and answer. We welcome questions for my phone, putting guests. Holding the microphone today is kerry miller. We have our first question please. Mr. Brousard commie talk about complexities facing the average american patient. Certainly insurance exchanges in the next year or so will make it more complex. [inaudible] in the drafting of the Affordable Care act. Why didnt humana and the others try to copy the systems of canada and other parts of europe like having a singlepayer take care of all medical expenses . s been a good question. We could probably be here quite some time to answer. From our vantage point, what we see if this is somehow works in canada and it does not have the care level here in the United States. Even in the European Countries like the u. K. , they too have a one payer system. What happens it is cause long lines and health care is delayed in getting to people in the result is a dear. It is a more simpler model under one roof or an ape in a society that can access care at a single point and village across the platform as a whole. We were governmental sponsored plan because it does not encourage innovation and does not encourage competitive aspects. We hope you will get better going forward. Slightly offtopic, [laughter] mr. Brousard, i want to comment and give you some background first. I am a humana prescriber through my wifes retirement. And generally very satisfied with the program, particularly enjoy the silver sneakers relationship to encourage exercise. I was pleased to mention the senior games in cleveland next year, 2013. I will be participating in spending because authority qualified because you have qualified the year before. My questions are multiple. First ill cut in Medicare Advantage plans have a fair amount of criticism during the discussion of the Affordable Care a does being more expensive and not performing at the level they should have. You maintain that you are doing well. I would like to know the Broad Spectrum on that . Then what just humana is doing, but ill been doing well. The other piece that goes with that is there is a lot of talk about saving of money from medicare to help fund the Affordable Care act. Part of that i thought was to reduce Medicare Advantage plans. How is that going to affect things . The third part of the question is, is there significant broad a statement to show a change in lifestyle has changed hope your cause curve downwards, not just yours. You got a lot of percentages. Im really looking at the total population. You might have to help me out because my memory is bad. I can only do one or two questions. Three is a little more complex. Youre exactly right. The one complaint with Medicare Advantage early on was that it is costing the federal government more than traditional medicare. It was really not about the