Humana (NYSE: HUM) is known as a major insurance company, but has recently established itself as a healthcare service company. Centerwells, including the Home Health segment, are a major part of this evolution.
PayVider plans to expand its home health services line to protect and grow market share while accelerating operational and clinical improvements and value-based arrangements.
“Centrewell is a significant part of what we're doing at this point,” Humana CEO Jim Retchin said at the company's investor meeting this month. “The insurance companies themselves have a much larger presence in Medicaid, and the way Medicaid and Medicare businesses work together is to provide health services at the end of the day.
Humana is one of the nation's largest insurance companies, with nearly 6 million Medicare Advantage (MA) members in its Health Plan. Centrewell is Humana's provider services division, including home hygiene, pharmacy and primary care.
Centerwell Home Health has 350 branches in 37 states providing skilled nursing and treatment services to patients in the home. Over 70% of Humana MA members live in the Home Health Service Area at Centrewell.
Humana executives said they plan to expand the company's home health services line, including growth during their tenure, to increase the density of the existing market.
“Skilled home hygiene is a fragmented space in which the top 10 providers represent less than 30% of their total market share,” said Dr. Sanjay Shetty, president of Centrewell. “This creates an opportunity to pursue strategic acquisitions and further builds on its proven ability to absorb new acquisitions on a scaled national platform.”
Shetty also said the company will launch a new supplemental outpatient service and expand its subsequent navigation model to more Humana Health Plan members over time.
“It's very powerful to have clinicians stay at home, people who can see patients and how they actually live,” Shetty said. “Our team spends time (understanding) personal goals and barriers to better health. My own time with this team shows that very specific targeting interventions can have a very large impact.”
In addition to assisting patients at home, Shetty said Centrewell's home care services department is designed to accelerate a value-based approach to care.
Centrewell is also investing in operational and clinical improvement initiatives that the company's leaders say will bring about reduced operating cost rates in the future.
“This includes programs that support more consistency and lower costs.
“We can also stay in touch with patients after discharge to avoid returning to the hospital. However, pivots to value require commitment to the role of home care to improve results, quality and experience. That is the possibility of a mature, integrated platform, and we see durable results from both our care delivery assets and acute navigation and management services.”
From a performance standpoint, Centrewell has secured solid investment returns in its home solutions segment despite industry-level rate pressures.
“As a leading provider of home healthcare, we have been able to leverage our size to increase operational efficiency and drive innovation across our entire national footprint,” Shetty said. “To help us transition to value, we continue to provide better patient outcomes and improved patient experiences. Furthermore, our home solutions are a highly complementary asset that significantly overlaps with our Humana Health Plan.
The company reported positive results, including reduced hospitalizations and improved total care costs.
“We've far above the industry average and recently posted results that put us at the top of our national peer set,” Shetty said.
