Private Payers News

Humana Tackles CKD Through Home Healthcare, Care Coordination

The payer has further expanded its chronic kidney disease management program to extend home healthcare and care coordination to Medicare Advantage members.

chronic disease management, care coordination, home healthcare

Source: Thinkstock

By Kelsey Waddill

- Humana will be partnering with a chronic kidney disease management and awareness organization to provide home healthcare and care coordination to Medicare Advantage members, the payer recently announced.

“This partnership is part of Humana’s dedication to innovation, especially in meeting care challenges presented by the coronavirus,” Amal Agarwal, MD, Humana’s vice president of transformative home solutions, said in the press release. “We’re committed to offering our members with kidney disease a modern, personalized strategy that provides synchronized care options.”

The payer is partnering with REACH Kidney Care, a nonprofit affiliate of Dialysis Clinic, Inc., in order to provide better kidney care services in Alabama, North Carolina, South Carolina, and Tennessee.

“We’re delighted to provide care management services through this agreement with Humana, as we mutually view each patient as an individual who deserves the best possible quality of life,” said Doug Johnson, MD, Dialysis Clinic, Inc.’s vice chairman of the board and co-founder of REACH Kidney Care.

Together with this new partner, Humana will be able to offer home healthcare options for more members suffering with chronic kidney disease. The home healthcare options encompass home dialysis. They also operate through greater care coordination, incorporating the beneficiary’s primary care provider and nephrologist in their care strategy.

“This whole-person approach to treating chronic kidney and end-stage renal disease provides our members greater choice and flexibility in their care, including for some the option for in-home treatment,” Agarwal said.

Moreover, Humana’s Medicare beneficiaries will receive better early detection care.

This announcement was coupled with the news that Humana would also be partnering with Strive Health to offer chronic kidney disease management and end-stage renal disease services in Kentucky and Indiana.

These partnerships expand the footprint of Humana’s chronic kidney disease programs, building upon previous partnerships established at the end of last year.

As of these announcements, the payer works with five provider organizations, including REACH Kidney Care and Strive Health, in at least 11 states to provide chronic kidney care options. The partnerships in December 2019 extended the program to Louisiana, Mississippi, Georgia, and Virginia.

These programs serve eligible Humana Medicare beneficiaries, including commercial and administrative-services-only plans. Care providers are responsible for conducting outreach to eligible beneficiaries to alert them that they may join for no extra cost.

“Humana and Strive Health are proud to advance a more holistic approach to treating chronic kidney and end-stage renal disease,” Agarwal said. “We are mutually dedicated to more seamless care coordination and an emphasis on greater patient engagement, both of which are particularly important as the nation continues to battle the coronavirus pandemic.”

The coronavirus pandemic adds an edge of urgency to partnerships like these.

Coronavirus patients with chronic conditions, especially chronic kidney disease and end-stage renal disease, are more likely to experience severe symptoms leading to poorer health outcomes as well as high healthcare spending. In May 2020, 15 percent of hospitalized coronavirus patients had acute kidney injury or loss of kidney function due to the disease.

Meanwhile, as patient costs escalate due to the pandemic, a new rule on Part D and Medicare Advantage end-stage renal disease care could boost costs even further in the new year.

In light of these circumstances, Humana chose to emphasize the incorporation of home healthcare for dialysis patients and greater care coordination, which can decrease healthcare spending as it did for South Dakota’s Medicaid program.

Other payers have also been turning to in-home care to help prevent worsening conditions for members in need of chronic disease management support and to support preventive care measures.

Blue Cross and Blue Shield of Minnesota (Blue Cross), for example, distributed diabetes and colorectal cancer preventive screening kits to members in their homes. Humana, likewise, distributed home healthcare preventive care screening kits for diabetes and colon cancer.