Humana Expands Value-Based Care Model to Cover More Seniors

Humana’s CenterWell Senior Primary Care (CenterWell) is expanding its value-based care model to Original Medicare members to improve care quality and health outcomes, as well as lower the cost of care.

CenterWell, a primary care provider that focuses on senior healthcare, is participating in the Direct Contracting Model which ensures that CenterWell’s reimbursement will be dependent on the quality of care it provides, according to the press release.

Under this model, CenterWell will also share financial responsibility for patients’ medical costs with CMS.

“The industry is moving away from a transactional model of healthcare, in which a doctor or other healthcare professional treats one specific condition, to a more holistic view in which we assess all of the patient’s needs and then develop a plan to address each of those needs,” said Reneé Buckingham, president of Humana’s Care Delivery Organization.

“We’ve deployed this value-based population health model for decades to care primarily for patients with Medicare Advantage, and now we can offer our model to more of those with Original Medicare.”

CenterWell provides care at 67 payer-agnostic primary care centers in eight states and is on track to expand to its ninth state this year.

The provider is a part of Humana’s care delivery organization which consists of care providers that serve more than 200,000 Original Medicare and Medicare Advantage members across the country.

The payer’s value-based care model previously covered mostly Medicare Advantage members but they are extending it to now cover more Original Medicare members as well.

“We are confident that our clinical model, supporting technologies, and analytics capabilities can make an impact in patients’ lives, while at the same time lowering healthcare costs,” said Buckingham.

CMS established its Innovation Center’s Direct Contracting Model to encourage healthcare organizations to voluntarily transition from fee-for-service to value-based care. Another goal for the model was to test if it would improve care quality and reduce costs for Original Medicare beneficiaries.

Back in March, Humana announced that its payer-agnostic senior services Partners in Primary Care and Family Physicians Group would transition into the CenterWell brand and going forward would be known as CenterWell Senior Primary Care.

“This new brand reflects the fact that our care-services businesses are growing and maturing – such as our payer-agnostic senior-focused primary care centers – and we need a brand that speaks to how we put our members and patients at the center of everything we do,” Bruce Broussard, president and chief executive officer of Humana said in a past press release.

CenterWell aims to practice whole-person healthcare which focuses on emotional and social wellbeing along with physical health.

Humana also expanded its healthcare coverage when the company signed an agreement to acquire the remaining shares of the Kindred at Home program.

The healthcare organization, which focuses on providing clinical care and support to patients at home, has 43,000 caregivers and serves more than 550,000 patients.

“We continue to invest in assets that allow Humana to better manage the holistic needs of our members and patients by expanding care in the home, including primary care, telehealth, and emergency room care, while also addressing social determinants of health,” Broussard said at the time.

Humana’s Direct Contracting Model launched on April 1, 2021 for Medicare beneficiaries.

“We’re honored that Humana Care Solutions is one of only 53 organizations selected to participate in this innovative value-based model, which strives to accelerate the shift away from fee-for-service across the nation while providing greater financial consistency for providers,” Oraida Roman, vice president of value-based strategies at Humana said in a past press release.

By expanding the value-based care model to cover more Original Medicare members, Humana aims to produce lower costs for beneficiaries and better-quality care.