For Humana, the national insurer with the most Medicare Advantage members, retail health clinics are out of the integration strategy, but home care is very much in.
Humana At Home, the home services unit of the Louisville-based managed care company, has acquired Your Home Advantage, a Florida-based provider of nurse practitioner in-home care operating in Florida, Georgia, Missouri and Texas.
Humana argues that the acquisition will boost its home-based services "through tighter connections with other clinical programs and integration of the care management team and related clinical data."
Humana members receiving services from the At Home unit have 42 percent hospitalizations and 56 percent fewer hospital readmissions compared to similar populations, according to data from the insurer.
Your Home Advantage was founded in 2009 and has been led by CEO Brent Hood, a former executive at Metropolitan Health Network, a Florida network of providers that Humana acquired in 2012. While financial terms of the deal were not disclosed, Your Home Advantage is already doing substantial business serving Humana members. The insurer and its subsidiaries accounted for around 70 percent of YAH's 2014 revenue.
"The capabilities that Your Home Advantage brings us will help Humana build on the significant clinical results that Humana At Home has achieved for our Medicare Advantage members living with chronic conditions," said Eric Rackow, MD, president of Humana At Home.
"Together we can foster a broader care platform that enables us to provide members more beneficial health-related services in the comfort of their homes," said Rackow, who's led Humana At Home since 2007, when it was known as SeniorBridge. "By shifting care to the home, we're better able to meet member needs as well as improve clinical outcomes."
Reimbursement pressure in Medicare Advantage--the federal government's gradual march to parity with traditional Medicare--is one reason Humana may have decided to add to its home medicine portfolio.
Another reason is to meet demand from seniors who are aging in place, in their own homes, or in independent living centers.
"Patients do not want to be institutionalized. Hospitals are dangerous places, especially for the frail elderly," said Constance Row, executive director of the American Academy of Home Care Medicine. "The field of geriatrics suggests that frail elderly should not be anywhere near the hospital unless they have to be. Nobody wants to go an ER or be hospitalized."
On the horizon, a Medicare benefit for home-based medicine "Really at the sweet spot at where everything is going in healthcare."