Humana Finds Success With Home-Based Strategy

Humana has stated that it “will serve as a partner in health and aging, delivering a personalized and simple experience through an integrated, value-based health ecosystem. Humana has declared home health as the new frontier in value-based medicine. The company is investing more than $100 million over the next three years to create a new team in Boston.

The clinical support and care provided by Humana At Home is designed to improve health outcomes and result in a higher number of days members can spend at their homes instead of in an acute care facility. At December 31, 2018, Humana had enrolled approximately 716,000 members, with complex chronic conditions participating in a Humana Chronic Care Program, reflecting enhanced predictive modeling capabilities and focus on proactive clinical outreach and member engagement, particularly for Medicare Advantage membership. These members may not be unique to each program since members have the ability to enroll in multiple programs. 

Humana has committed additional investments in its home care capabilities with the acquisition of a 40% minority interest in Kindred at Home, Inc., or Kindred at Home, and Curo Health Services, or Curo, which combined creates the nation’s largest home health and hospice provider with 65% overlap with the company’s individual Medicare Advantage business. Kindred at Home has over 375 sites of service, with 50,000 caregivers serving over 100,000 patients daily.

Humana’s decision re-imagine its Medicare Advantage operating model from the customer back is working out. Humana experienced strong Medicare Advantage (MA) growth in the second quarter of 2019. Humana raised its full-year expected individual MA membership growth from 415,000 to 440,000 members to a range of 480,000 to 500,000 members for 2019.

One factor sparking the recent increase in MA enrollment industry-wide is the addition of in-home non-medical supplemental benefits, which includes services such as home care and transportation. Humana offers several of those benefits through partnerships.

Humana is piloting value-based care models through its investment in Kindred at Home in multiple markets and stated that it continues to see encouraging results from a stand-alone financial perspective for Kindred at Home and from the standpoint of delivering improved clinical outcomes for its members.

Humana and Kindred at Home have invested in an interdisciplinary team of clinicians responsible for taking the best practices learned from pilot markets and applying those across Kindred’s geographic footprint. In the pilot markets, Humana has seen 1,800 home health episode authorizations year-to-date under the new value-based model compared to 600 in all of 2018.

The expanded coverage include — area includes 6 states, Georgia, Kentucky, North Carolina, South Carolina, Virginia and West Virginia, representing over 90 Kindred at Home branches. For the full year, Humana expects a total of nearly 20,000 home health episode authorizations under the new value-based model for both pilot markets and expanded coverage areas.