How Humana uses data to bring patients back to the doctor.

From the hospital to the home, Humana uses Salesforce to help members prioritize their health.

Time to read: 6 minutes
Humana differentiated itself from competitors in a major way: It became an insurance company that people actually like to hear from.

Over its 60-year history, the major U.S. public health insurer has navigated many industry disruptions, from national health crises to the rise of telehealth. Today, Humana is well into the next chapter of its evolution into a health and wellness company that drives people toward the healthcare system, instead of away.

“The industry as a whole is laden with confusion and options,” said Chris Walker, Associate Vice President, Engagement Marketing. “And that’s the challenge — how do you build trusting relationships at scale?”

Building trusting relationships that encourage member engagement requires the technical infrastructure and strategic guidance to make it happen. That’s why the company chose Salesforce to unite teams, partners, and caregivers around a shared view of member data. With a single source of truth for member profiles, interactions have gone from simple claim processing to personalized support throughout each member’s wellness journey.

“Everybody has their own unique journey and healthcare needs,” said Walker. “And it's so important to be able to treat individuals as individuals.”

Humana makes the path to wellness easier with tailored messaging, service, and care coordination that keeps these members at home — instead of the hospital. In fact, the company now delivers care three to four times faster and saves $6 million in information security costs in the process.

Let’s see how Walker and his team create exceptional care experiences with the power of empathy and connected data with Salesforce Customer 360.

“To build trust with your members, you need to really know them — and data tells their story.”

Chris Walker

AVP, Engagement Marketing

1. Send proactive messages to get members’ health back on track.

Getting people to make their health a priority goes beyond reminding them to go to the doctor. If a member receives a life-altering diagnosis like Type 2 diabetes, for example, the company proactively reaches out with clinical and emotional support.

“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,” said Walker. “That means consistently showing up in the meaningful moments.”

Humana is doing that with Marketing Cloud tools for member engagement. Following a Type 2 diabetes diagnosis, for instance, the member receives email tips for managing the disease or a list of answers to frequently asked questions about insulin administration. They can also receive text alerts that a care provider will call them in a few hours.

“Marketing Cloud makes it a lot easier for us to stay in touch with our customers,” said Walker. “It really allows us to hone into that moment, in their preferred channel, and deliver something that's relevant for them.”

On the other side of these interactions, Humana knows which channels members engage with these messages. If text works better than email, the company will engage members there as well.

Humana’s sales teams also use Marketing Cloud to customize 60 different prospect journeys, yielding 1,000 interested employer leads per year. Marketing Cloud Intelligence, powered by Datorama, has improved sales outcomes by helping the company identify more business customers and reach out with personalized messaging.
To create these opportunities, Humana engages group agents who haven’t sold in a while with communications that speak to their unique needs. Re-engaging these agents has resulted in more deals closed and a boost in cross-selling efforts, including automated cross-selling upon renewal.

2. Deliver care four times faster by connecting member data.

From health records to service interactions, Humana collects an enormous amount of member data. This is as challenging as it is beneficial, especially if the data lives in different places.

MuleSoft’s API-led integration capabilities connect data from legacy systems to Salesforce. This creates the full view of member data that care teams need to provide exceptional healthcare experiences — up to four times faster.

“Data tells each customer’s story, and that data is super rich when you bring it together to create that 360-degree view of the customer,” said Walker.

For instance, if a member requires extensive post-op care after a knee replacement, their care team already has a shared view of their medical history, relevant lifestyle information, and future appointments. This lets the member focus on recovery instead of personally updating every clinician they see.

“Whatever they’ve received a diagnosis for,” said Brian Cahill, Vice President, Pharmacy Segment CIO. “We’re going to partner with their doctor to make sure that they’re properly treated and that they have the right programs surrounding them.”


3. Improve outcomes by coordinating specialist care around a 360-degree view of the member.

Humana’s mission to put the patient at the center of the healthcare experience is about more than responding to an industry trend. It’s a matter of helping members live happier, healthier lives.

If a member is diagnosed with a severe illness such as breast cancer, the care team — a dozen specialists spanning surgery, radiation, and genetic counseling — needs a 360-degree view of the member’s health data to quickly put a plan into action.

Humana’s Enterprise Clinical Operating Model (ECOM), powered by Health Cloud, gives care teams the agility they need to deliver comprehensive and compassionate care. This integrated platform lets clinicians access a full view of each patient’s medical history, medications, and lifestyle information while simplifying clinical workflows.

For example, doctors and care teams can view a cancer patient’s most recent lab results, plan next steps for care, and coordinate home services from a single place. If an oncologist needs to make changes to the patient’s medications, the pharmacist, at-home caregiver, and behavioral health specialist on the team get updated immediately.

But sharing this much patient data requires a scalable security solution integrated into each platform. Built on the Salesforce Platform, Shield keeps each member’s information safe on Humana’s website with data encryption and other best-in-class security requirements. So far, Humana has saved $6 million in security-related costs.
“Our ultimate goal is that members see us as a trusted partner who can provide the services they need in a very timely manner,” said Cahill.

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4. Deliver unparalleled convenience with a HIPAA-compliant digital pharmacy.

To ensure that its members receive their prescriptions on time and without hassle, Humana built its first-ever HIPAA-compliant digital pharmacy on Commerce Cloud — the CenterWell Pharmacy.

This digital pharmacy lets members refill prescriptions, check order statuses, and even send prescriptions to different pharmacies. If members on medication for osteoporosis want to spend the summer in another state, for instance, they can send their prescriptions to a closer pharmacy in Humana’s network. They can also reach out via chatbot if they have questions for the pharmacy team.

“Our aim is to make sure we’re getting those life-saving medications to our customers so that they can achieve their healthiest lives,” said Cahill.

But how does a digital pharmacy meet HIPAA standards? That’s where Shield comes into play. Shield provides an airtight security solution by encrypting sensitive health data and only allowing authorized users to access it. This way, members can use the CenterWell pharmacy with the confidence that their information remains in trusted hands.

“Having that single source of truth helps you master your data and know how to share your data. Only the member or the entity that needs their data can access it.”

Brian Cahill

VP, Pharmacy Segment CIO

5. Evolve the business of health with strategic guidance at every step of the journey.

Evolving from insurer to trusted healthcare partner takes more than choosing the right technologies. It takes strategic guidance from experts dedicated to bringing your vision to life.

That’s why Humana chose Salesforce Professional Services for implementation oversight and best practices on how to build for long-term success and maximize value from its Salesforce ecosystem. By aligning on a vision, the team of experts designed a solution to help the company reach its goals faster, ensure a seamless transition to Health Cloud, and launch its first-ever HIPAA-compliant digital pharmacy on Commerce Cloud.

“Salesforce Professional Services has been a great partner on this journey with us, making sure we get the most of our investment, and we’re seeing value fast,” said Walker.

Given the high stakes of Humana’s operations, even a few minutes of downtime can have a huge impact. To minimize downtime and disruptions, Humana relies on the Signature Success Plan to monitor performance, errors, and platform limits. This helps inform the company of any potential risks before they impact system performance. The Signature team also delivers proactive, personalized expertise to help Humana reduce technical debt, innovate faster, and eliminate security risks.

With Salesforce Professional Services and the Signature Success Plan, Humana can confidently deliver more personalized member experiences at scale.
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