Humana Sets 50-Percent Value-Based Target for Medicare Advantage Members
Building on recent acquisitions and a de novo growth push, Humana Inc. executives say they want to have roughly half of their 5 million Medicare Advantage members covered by value-based home health arrangements in five years.
Speaking to analysts and investors on the heels of his team’s recent third-quarter earnings report, President and CEO Bruce Broussard said Louisville, Ky.-based Humana has “made substantial progress toward our goal of scaling and maturing a risk-bearing value-based model” that comprises home health, durable medical equipment and home infusion, among other things. The company is today caring for about 270,000 people in South Florida and Southeast Texas under value-based home care models and Broussard said those programs have lowered expensive emergency room usage to the point that they are a full percentage point below Humana's national average.
Up next for Humana, which has grown its Medicare Advantage member base by nearly 40% since 2018, is an expansion of that program to parts of North Carolina and Virginia slated for the second quarter of next year. Broussard said there are significant opportunities to lower home care costs there, helped by the presence there of Kindred at Home, which Humana took over in August after paying an investment consortium $5.8 billion for the 60% of the venture it did not yet own.
“We have the capabilities to be a value-based convener providing risk-based contracting and referral management and continue to develop technology enabling us to coordinate with other adjacent services,” Broussard said.
Lowering costs while maintaining and improving care is one of the promises of value-based home care. But, former Blue Cross and Blue Shield of Minnesota President and CEO Craig Sammit last week told a panel convened by the Leonard Davis Institute at the University of Pennsylvania, paying providers as much for an in-home visit as for one in a traditional setting could incentivize higher utilization rates.
“Payers are very rapidly going to be more likely to fully endorse the use of care at home if systems and payers are jointly accountable for the total cost of delivering care, regardless of setting,” Sammit said.
Kindred at Home’s operations will soon be rebranded to CenterWell, the healthcare service brand Humana rolled out early this year. Under that umbrella, the company also is pushing ahead with plans to grow its senior-focused primary care business, which will have about 200 care centers in nine states by year’s end. Humana has opened 24 clinics this year – with Atlanta and Houston among the focus areas – and plans to ramp that number to 30 in 2022, including in new markets Dallas and Phoenix.
Shares of Humana (Ticker: HUM) ended trading Nov. 15 at about $438. They have over the past six months lost about 3% of their value.
