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Humana has reached an agreement with two national organizations to provide Durable Medical Equipment (DME) services to help Humana Medicare Advantage HMO members receive home healthcare.
The national DME providers, AdaptHealth and Rotech Healthcare, will begin providing DME services for Humana’s Medicare Advantage HMO enrollees under a value-based structure beginning July 1, with each serving a specific region of the country.
Humana framed the partnerships as part of a push to expand value-based care across its slate of home health services through its onehome subsidiary and its entire Home Solutions business. As part of this commitment, one of the company’s top priorities is to build and scale a value-based home care offering that covers 40% of Humana Medicare Advantage members by 2025.
WHAT’S THE IMPACT?
With the move, Humana signaled its intent to create a more unified approach to the sourcing of durable medical equipment – one the company hopes results in a more coordinated experience for Medicare Advantage HMO members, as well as physicians and other healthcare professionals.
Humana expects that the sophistication and scale of these DME organizations can help drive greater value for members, and, as Humana more closely collaborates with these DME providers, members will receive a higher level of service, the company said.
For healthcare providers, the approach is designed to simplify and speed the process of ordering and obtaining medical equipment for patients.
Humana and the DME companies are in the process of communicating this transition to Medicare Advantage HMO members, Humana said. The DME organizations will also begin directly contacting members who currently receive DME services to ensure all medical equipment needs are cared for once the new contracts take effect.
The move pertains to Humana Medicare Advantage HMO plans. It does not pertain to Medicare Advantage members enrolled in PPO or private fee-for-service plans, or Humana’s Medicaid, commercial or TRICARE lines of business.
THE LARGER TREND
Humana posted strong financial results for the first quarter, driven by its Medicare Advantage and managed Medicaid business, its senior-focused value-based primary care platform CenterWell and the award of the TRICARE military contract.
Individual Medicare Advantage membership grew by 17%, at least 775,000 members, in 2023. In highly-penetrated value-based markets in Texas, Georgia, Florida and Illinois, MA membership has grown nearly 13% year-to-date, according to Humana president and CEO Bruce Broussard.
Just this week, Humana said it was teaming with Longevity Health plan to expand special needs health plan offerings that support the requirements of Medicare-eligible patients living in skilled nursing and senior living facilities.
In February Humana said it will be exiting the Employer Group Commercial Medical Products business, which includes all fully insured, self-funded and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. The insurer said it will be exiting the business in a “phased manner” over the next 18 to 24 months, and will shift more of its focus to government-funded programs and specialty businesses.
ON THE RECORD
“Partnering with national DME partners under a value-based arrangement aligns with our goal to enhance access to the home care services we provide to patients across the country,” said Kirk Allen, senior vice president of Home Solutions at Humana. “We’re excited about the partnerships we’re announcing today because working with these organizations on a national level will help us streamline and simplify our efforts to get Medicare Advantage HMO patients the equipment they require with best-in-class service, while empowering health care providers to more efficiently fulfill their patients’ DME needs. These deeper relationships will also enhance our ability to deploy clinical programs aimed at reducing hospitalizations for our members.”
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