What Do We Do Now?

Representing one of the nation’s largest health and wellness companies, Rhonda Bagby, market VP for Humana’s Employer Group Segment in Louisiana and Mississippi, offers advice to local businesses in uncertain times.
David Joshua Jennings

If you look at the major players when it comes to employer health insurance in Louisiana, Rhonda Bagby is high up on that list. Representing one of the state’s largest insurance providers, Bagby is market vice president for Humana’s Employer Group Segment in Louisiana and Mississippi.

Humana is currently the third largest health insurance company in Louisiana in terms of membership and revenue. With Medicare premium volume considered, they rise to No. 2. Within Humana, Bagby leads employer-focused business, including group sales and distribution and relationship management and is responsible for overall commercial operations, including medical and specialty benefits.

At a time when costs keep climbing, the company also differentiates itself by its strong focus on wellness, encouraging and assisting individuals and employers via various methods to focus on improving health in order to lower premiums.

Biz: Can you tell me a little bit more about Humana?

Bagby: Humana is a national company based out of Louisville, Kentucky. It has more than 14.2 million medical members across all 50 states, Washington D.C. and Puerto Rico. Humana employs 50,100 associates, had $54.4 billion in annual revenue in 2016 and ranked 52 on the Fortune 500.

In Louisiana, Humana entered the market when the Ochsner health plan was purchased in the mid-2000s. In this market, we cover — between employer group, individual products and senior products — more than 600,000 people.

"When you look at national health rankings, Louisiana is right at or near the bottom, regardless of who conducted the study. We’re thinking about how we can change that."

Biz: How concerned should employers be about instability in healthcare?

Bagby: As we stand here today in 2017, most of the changes in the employer group market that were part of the Affordable Care Act (Obamacare) have already been implemented. For employers, it’s important for them to be alert to what could happen if changes are made in the future. We encourage a focus on achievable solutions. A happier, healthier workforce is going to cost less to provide health care going forward. So focus on the things you can control and influence while monitoring things at a national level.

Biz: Humana is pulling out of offering individual insurance at the end of this year. Why?

Bagby: That was a decision that our company made on a national basis. The decision to exit individual products nationwide effective at the end of 2017 was based on the losses that we had sustained in that business over the past few years. It is just not a situation that is sustainable. So we made the decision to exit that business and focus our resources on our employer group business, our Medicare business and our health services division.

Biz: How stable is Medicare?

Bagby: I think the outlook for Medicare is good. When you look at the market opportunity that’s there for Medicare with the number of people that are turning 65 in our aging population there is a strong market because of the pool size.

Biz: Healthcare premiums have been on a steady increase. Are there ways employers can decrease premiums?

Bagby: Health care costs and affordability are top of mind with employers. From 2006 to 2016, the average cost of a family premium went from $11,480 to $18,142 —a 58 percent increase over that 10-year time period. When you break out the portion that was covered by employers and the portion that was employee cost shared during that same 10-year period, the employee cost share went up about 78 percent.

Employers are at a point where they really can’t solve the cost problem by cost shifting higher deductibles, higher co-insurance and those types of things to the employee. So what we have to look at closer is how can we improve the health status of the population that we’re covering. This is one of the reasons that Humana has put such great emphasis on wellness programs as part of the medical coverage. We are working closely with employer groups to create a culture of wellness in the workplace. We know that people spend a lot of time at work and the health habits of your co-workers can be influential on you. So we’re encouraging employers to create healthy work environments and encourage people to live healthier. Over time, it will cost less money to be able to provide health care coverage to healthier individuals.

A lot of health care costs are rooted in obesity, diabetes, high blood pressure, smoking, stress and depression. In all of those areas, if people can make changes to their diet, exercise, stop smoking, start to better manage their stress, they can make remarkable strides in their overall health and wellness, and that can have an impact on their health care costs. We’ve put a lot of effort into researching and understanding these conditions. The only true solution to affordable health care is improving the health status of the population.

Biz: Can you talk a bit about Humana’s shift to value-based care?

Bagby: Value-based care is the thinking of moving away from paying a fee for service and paying for services as they’re done without, really, any regard to quality or why you’re doing it to moving to where incentives are aligned between payers and providers and the member is at the center. You’re looking always at what is the best, most effective, cost efficient treatment for a particular member. Humana has some value-based arrangements in Louisiana in some areas, and has made some progress.

"A lot of health care costs are rooted in obesity, diabetes, high blood pressure, smoking, stress and depression. In all of those areas, if people can make changes to their diet, exercise, stop smoking, start to better manage their stress, they can make remarkable strides in their overall health and wellness, and that can have an impact on their health care costs."

Biz: How is Humana embracing technology?

Bagby: Humana competes in the marketplace on wellness and technology. We know people are increasingly using self service and relying on technology to do things themselves. With our Go365 Wellness & Rewards Program we have a really good mobile app. Our technology is so easy now that I can go do a 10K, take a picture with my bib on, upload that picture, and get my rewards points. It’s that simple.

We’ve invested a lot of effort into technology to make the member experience better and to become more efficient. We do continue to work with our various technology partners to figure out how we can take things to a further level. Our goal with technology is always to make the member experience better, the provider experience better, the employer experience better by making things simpler, faster.

Biz: What are Humana’s guidance centers? When did they open? Where are they locally? What do they provide and to whom?

Bagby: There is a Humana guidance center on Veterans in Metairie, and there’s also one in Baton Rouge. The Humana guidance centers are places where people can get information about Humana, seek customer service support, participate in exercise classes, learn about nutrition, and do things like play cards and games. We’re looking at ways to expand those because people do like the ability to walk into that storefront atmosphere and the vibe they get from the centers. 

Biz: Both Baton Rouge and New Orleans are considered “Bold Goal Markets” for Humana. Can you explain what this means?

Bagby: Across the country, Humana has eight markets that are designated as Bold Goal Markets. They are markets where Humana is committed to improving the health of the communities that we serve 20 percent by 2020. These are markets where we feel that we have a strong brand, a strong market position, and strong relationships within the market so that we can make a difference not just for our customers, but also on the entire community. These are markets where we’re investing time and resources and effort to improve health in the community. We’re working with community partners through our advisory boards in New Orleans and Baton Rouge. Some of the conditions we’ve prioritized are diabetes, congestive heart failure and mental health.

Biz: How does Louisiana compare to other states Humana covers? What are our biggest challenges and strengths?

Bagby: When you look at national health rankings, Louisiana is right at or near the bottom, regardless of who conducted the study. We’re thinking about how we can change that. Obviously in Louisiana we live in an area where we have inordinate obstacles to healthy living. Just our culture — we live in this culture of abundance, great food and all of those kinds of things. But there are ways that we can preserve those cultural legacies, so to speak, but also make changes. Chefs have tweaked a lot of Louisiana recipes and restaurants are offering healthier versions of some of the traditional New Orleans foods on their menus. We’re also encouraging people to get fit and move more. Some of the biking and walking paths that are in New Orleans and Jefferson, St. Tammany and St. Charles are really good things.

At the end of the day, when you look at why people have certain health conditions, a lot of it really is rooted in the choices we make on a daily basis. So much of your health is within your own control with the decisions you make about what you eat, whether you exercise, whether you smoke, how you manage stress, and how well you sleep at night. Through making positive changes in your life, even if it’s a few steps at a time, you can make a difference in your health.

Biz: Best advice for employers when it comes to deciding on an insurance provider?

Bagby: The best advice I can give is to not make the decision based on price year-to-year, but to look for a carrier that you can partner with to get your employees engaged in improving their health and wellness so that over time you can reap the benefits of a healthier workforce.

More about Rhonda Bagby

Bagby began her career in health care at age 16, working in the business office of a community hospital in her hometown of Cleveland, Mississippi, a Delta town roughly in-between Memphis and Vicksburg. After earning bachelor’s and master’s degrees from Delta State University — “Home of the Fighting Okra” — she joined an accounting firm in Jackson, which started doing audit work for the Mississippi Department of Insurance. She served as UnitedHealthcare’s vice president of finance/operations for Alabama, Louisiana and Mississippi before joining Humana in 2005.

In addition to her career, Bagby serves on the board of directors of the St. Tammany West Chamber of Commerce and as chair-elect for 2018. She is on the board of directors and serves as membership committee chair for the Northshore Business Council, is on the Health Care Committee of the Jefferson Parish Chamber and is a member of the Business Council of New Orleans.

Largest Health Insurance Providers in Louisiana in 2016

(in terms of market share/revenue)

1. Blue Cross/Blue Shield — encompasses Louisiana Health Service & Indemnity Company and HMO Louisiana Inc.

2. UnitedHealthcare Insurance Company

3. Humana Health Benefit Plan of Louisiana


Favorite book? “The Blue Zones” and “The Blue Zones Solution.” The first book resulted from a National Geographic project that looked at areas of the world with the most centenarians. There were seven areas that researchers looked at to understand their lifestyles and health habits. The second book is about how you can take the best practices they learned and apply them to modern life. I probably talk about something in these books at least once a week.

Favorite TV Show? I’m a huge sports fan, so I watch talk shows like Mike & Mike on ESPN. Most of the time when I watch TV it’s for informational purposes more than entertainment purposes.

Who do you look up to? I look up to my mom. She raised me as a working mom, and I’m raising my kids as a working mom. I think there are some good lessons that you can learn from people who deal with challenges and balance things in life.

Biggest life lesson learned? Just because you can do something doesn’t mean you have to. A lot of times we get requests to do things and we can spread ourselves too thin. I think you have to really think about where you want to spend your time and resources and prioritize on that basis.

Best advice ever received? I’ve received a lot of advice, but one thing I say to my kids on a regular basis is that when I look back on my life I regret more so the things I didn’t do than the things I did do. There are a lot of applications to that, when you think about going to a wedding, or funeral or to visit family. Sometimes when you do things that aren’t the most convenient for you, you find out it’s been a good experience.

Hobbies? I do some walking, running, yoga and Pilates. No competitive sports at this point in my life. I do fitness things that I can do on my own schedule.

Pet peeve(s)? Procrastination. I’m the type of person that if I say I’m going to get something done, I like to get it done. I work off of a to-do list, and I like to check things off of it. Procrastination is something that really bothers me.

Click here to see the Beyond The Magazine with Rhonda Bagby

Categories: Healthcare, The Magazine