Technology and value-based care are driving a new healthcare ecosystem that Humana discussed in detail at an investors day conference on Tuesday. The company is leveraging its Medicare Advantage plans, along with investments in home care and in-home primary care, to improve patient outcomes and reduce costs.
“These capabilities are really to drive a more holistic and proactive healthcare system,” Humana President and CEO Bruce Broussard said.
Humana presented the roadmap for a comprehensive value-based home healthcare model one day after announcing the acquisition of One Homecare Solutions, also known as onehome, which offers integrated services through a value-based, full-risk care model.
Humana Home Business President and interim CFO Susan Diamond said onecare will serve a central coordinating role. Health plans will negotiate a capitated payment with onehome care that will deliver savings to the health plan. Onehome, for its part, will create optimized care plans designed around patient outcomes and the total cost of care. It will then refer patients to home healthcare agencies, including Humana-owned Kindred at Home.
“Kindred and other high-quality home health agencies will be asked to address a broader set of patient needs, reducing preventable hospitalizations and total cost of care through enhanced clinical models that we intend to implement,” Diamond said.
In recent years, Louisville, KY-based Humana has transformed itself from an insurance company to a health and well-being company. Along with its recent acquisitions of onehome and Kindred at Home, the company has also expanded into primary care with its CenterWell brand and partnered with in-home primary care providers, including DispatchHealth and Heal.
Diamond said Humana is laser-focused on keeping patients out of the hospital, estimating that an in-home primary care visit costs payers roughly 80% less than a trip to an emergency department.
“All in all, we believe most preventative and advanced illness care can be provided in the home. And, anywhere from 20% to 100% of acute care can also be best served in the home. Clearly there is significant opportunity here,” Diamond said.
Human explores kidney care
Humana is also exploring partnerships with kidney care companies to collaborate on interventions to slow the progress of kidney disease, which affects approximately 37 million Americans. Those partnerships could pave the way for in-home dialysis treatment, which is gaining traction in the U.S.
Diamond said the model of care Humana is creating, combined with the company’s geographic footprint could broadly influence the delivery of care nationwide.
“Over time, as we demonstrate the impact this model can have, we intend to work with (the Centers for Medicare and Medicaid Services) to advocate for the introduction of similar value based models and fee-for-service Medicare as well, which creates even greater opportunity,” Diamond said.