Simulating a Better Health Care System

“The health care system in the U.S. is broken — we know that,” said Scott Wallace, a professor at the Darden School of Business at the University of Virginia. “We can get less care, spend more or find a way to get more value for our money by improving the ratio of healthy outcomes to dollars spent.”

With that idea in mind, Humana Inc. and the Santa Fe Institute invited health care professionals from organizations such as the American Medical Association, the University of Chicago and other regional hospitals to participate in a simulation program last February in Santa Fe, N.M. In one of several Health Economy Simulator (HES) events developed by Humana, five teams of doctors, hospital administrators, government administrators and payer representatives teamed up to compete against all Humana customers from the region over two days in a race to improve the health of their particular region’s population by 2015.

Humana, headquartered in Louisville, Ky., is a Fortune 100 health care company that offers insurance products and health and wellness services. With 35,000 employees, Humana serves more than 17 million health plan members in the U.S.

The Humana Leadership Institute, the company’s internal leadership development organization, created the HES to help accelerate health care innovations in the market, region by region.

Within minutes of arriving for a simulation, Humana customers, health care providers and local health economy stakeholders are assigned a team and a role — hospital administrator, doctor, payer, government administrator or employer — and immersed in an experiential learning environment designed as friendly competitions with five teams of five to seven members.

Once engaged in the simulation, the participants work together to make dozens of choices for their region, including setting health care taxes and pricing, and investing in various programs and policies for hospitals, doctors and patients. The simulation software allows each team to explore the system-wide benefits by choosing different variations of the aforementioned decisions. They receive immediate feedback on how these decisions impact key performance indicators.