Humana Crafts Long-term Care Health Facility / Home Care Office Direct Contract Plan

Humana Crafts Long-term Care Health Facility / Home Care Office Direct Contract Plan


In March, Humana Inc. (NYSE: HUM) announced a new brand that integrates “Primary Care Partners” and “Family Physicians Group” into one.

Two payer-agnostic, senior-focused humana sects are now CenterWell Senior Primary Care. The newly named Senior Care Organization is now challenging its own Medicare through a direct contract with the federal government.

“Everything in CenterWell was designed with the elderly in mind,” Humana Chief Growth Officer Matt Eirich told Home Health Care News in an email. “By combining this with a value-based reimbursement model, we can invest in aggressive care and time to see patients regularly, not just when they are ill, and to manage their condition. . “

CenterWell and Humana’s Conviva Care Center together form the Humana Care Delivery Organization. Center Well Care Solutions was founded in collaboration with the Medicare and Medicaid Innovation Center (CMMI) as an entity operating on its global and direct contracting model, while Conviva has become a model through the Humana Direct Contracting Entity tag. I am joining.

Both are primary care organizations focused on the elderly and take a holistic approach to care.

Together, they operate more than 160 centers nationwide and serve more than 200,000 patients.

Direct contracts allow approved entities to enter into traditional Medicare risk sharing contracts. The goal is to save money and provide better patient care.

Humana is bullish on the potential for success as a direct contractor (DCE) and believes that model fits perfectly with what the payment system is trying to achieve.

“Although we invest much more in primary care practices than average practices, our model prevents avoidable hospitalizations, provides better results for patients, and broader medical care. It saves money on the system, “says Erich.

As with all DCEs, CenterWell refunds are based on their track record and the quality of care that new Medicare patients receive. During the term of the direct contract, we share financial responsibility with the Medicare and Medicaid Service Center (CMS).

Direct contracts extend the already large number of patients that CenterWell can provide care for.

“By participating in a direct contract, we can serve more patients,” says Erich. “Approximately 65% ​​of all Medicare recipients subscribe to the original Medicare. [Additionally], CMS shares data, enables more customized patient care and services according to patient needs, and provides a reimbursement model that allows investment in preventative and proactive care. “

Humana is currently in progress Buy the remaining 60% of Kindred At Home The corporate value is $ 8.1 billion. Kindred, one of the country’s largest home health providers, will eventually become Center Well Home Health.

Ultimately, Kindred at Home has offices in 40 states and provides home health care, hospice, and community-based services to more than 550,000 patients annually.

The CenterWell Senior Primary Care mission and its direct contract efforts are also in line with what Humana is trying to do at home.

“As family doctors, we very much believe in the power of the home as a patient-friendly environment of care,” Erich said. “We designed the care model to maximize the time patients spend at home, on the go, and at other facilities, and coordinate care with others in the home ecosystem, including Kindred at Home. . “

Direct contracts facilitate more comprehensive care for Medicare recipients, allowing Humana to leverage home care features to accommodate new patients undertaking.

Humana Crafts Long-term Care Health Facility / Home Care Office Direct Contract Plan

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