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Humana’s Population Health Research

Humana’s Population Health Research is Supporting Physician Efforts to Treat Members with Diabetes
Business Wire Humana Inc.


Humana Inc. (HUM) has published work in the Journal of Diabetes and Its Complications that makes it possible to use a tool called the Diabetes Complications Severity Index (DCSI) with the type of data currently available in claims submitted to health plans. The research publication is available here.

More than 9 percent of the U.S. population has diabetes, according to the latest estimates from the Centers for Disease Control and Prevention. Diabetes is one of two clinical areas that have been selected for emphasis in Humana’s research and disease management initiatives during 2017.

“Humana is committed to furthering our own and others’ population health goals,” said Roy A. Beveridge, MD, Humana’s Chief Medical Officer. “This work allows us to take a big step forward in providing the data that we and the physicians we collaborate with can use to improve outcomes for members living with diabetes.”

By combining claims data regarding diagnoses, the DCSI system results in a score that expresses the number and severity of complications and other diseases that people with diabetes often have. In other words, it provides a measure of diabetes severity. The original DCSI system was developed when researchers and health plans used a coding system called the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to identify patients’ diagnoses. In 2015 health organizations in the United States started using an updated coding system called ICD-10-CM.

Humana is the first group to publish a DCSI system that uses ICD-10 codes instead of ICD-9 codes. The authors of the study, two data scientists and a physician with disease management experience, matched ICD-9 codes with equivalent ICD-10 codes create new rules for assigning a DSCI score. They also made adjustments that allowed the score to more precisely represent different clinical conditions.

To confirm that the new scoring system was accurate, the researchers reported analyses showing that patients with higher DCSI scores based on the revised system also had more deaths and more inpatient hospital admissions. They used data from more than 800,000 individuals who were enrolled in Humana MA plans October 2014 through January 2016 for this analysis.

Vipin Gopal, Ph.D., Enterprise Vice President and head of Clinical Analytics, adds “We are pleased to be able to facilitate the efforts of all researchers in the field of diabetes. The improved tool will allow more accurate identification of members’ disease progression, as well as more accurate assessment of the effectiveness of programs designed to keep members as healthy as possible.”

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at, including copies of:

  • Annual reports to stockholders
  • Securities and Exchange Commission filings
  • Most recent investor conference presentations
  • Quarterly earnings news releases and conference calls
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