Humana Inc. (NYSE: HUM) leaders see home-based care as a longer-term opportunity that has the potential for continued expansion. They also view it as complementary to many of their other long-term goals, but namely the further pursuit of value-based care models.
They expressed these sentiments during a presentation at the BofA Securities Healthcare Conference on Tuesday.
“We’re a big believer that home is an opportunity for a lot of expansion, all the way from expansion of clinical models that we’re able to utilize there, and the type of services that are offered in the home,” Humana CEO Bruce Broussard said. “We look at home as being a trajectory of a longer-term opportunity for us.”
In addition to being one of the larger insurers in the U.S., Humana also has its health care services arm, CenterWell. CenterWell Home Health boasts one of the largest home health networks in the country, a network formerly known as Kindred at Home before Humana acquired it.
Humana is leveraging that network to roll out value-based models to the majority of its Medicare Advantage (MA) members in the coming years.
“We also see the home as being very complementary,” Broussard continued. “And when we think about integration of our various CenterWell assets, it is a leverage point for us and convenient for our members to [receive] more services in the home while utilizing our primary care assets.”
Broussard mentioned that while home health care is currently a fee-for-service business, it needs to evolve to become more value-based. Again, that is one of Humana’s goals within CenterWell in the coming years.
For context, the majority of CenterWell Home Health’s revenue is still driven by fee-for-service Medicare, though it is payer agnostic and is working toward more risk- and value-based payment models.
That, in the end, will allow the home to be the setting of care that saves costs for Humana – and the overall health care system – down the line, Broussard believes.
“It’s a model that we feel is important not only for cost effectiveness of the home, but for really utilizing the home to be more proactive in managing care downstream, preventing emergency room visits, admissions and slowing disease progression,” he said. “We just see that opportunity being significant for us in the future.”
CenterWell is in the business of providing services, while Humana’s insurer arm is in the business of managing services for beneficiaries.
But Humana’s leaders believe there is a natural and sensical way to merge the incentives for both sides of the house.
“[When we worked with] Kindred in that JV structure, we found it difficult to innovate,” Humana CFO Susan Diamond said. “Our incentives were not fully aligned. So now, by integrating and having a health plan as well as the home health asset – and being able to fully align our incentives and optimize the enterprise value for each – we don’t have to worry about the margin on an episodic visit versus a fee-for-service visit. And we think that’s important and necessary for the level of change that needs to take place in the way home health care operates today.”
Broussard predicted that home health care in a decade will look “far different” than how it looks today.