Humana eyes kidney disease in 13-state Interwell Health partnership

Photo: Raymond/Gehman/Getty Images

A new partnership between Humana and kidney care management company Interwell Health will result in a new value-based care agreement in 13 states for most Humana Medicare Advantage HMO and PPO members living with chronic kidney disease (CKD), as well as members across the country living with end-stage kidney disease (ESKD).

Under the arrangement, members will be able to access Interwell's care and specialized resources, including 1,700 network nephrologists and renal care coordinators; and in-home virtual support from dietitians, nurses, social workers, pharmacists and care coordinators.

The 13 states covered in the partnership are Arizona, Arkansas, Colorado, Kansas, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas and West Virginia.

WHAT'S THE IMPACT

The announcement comes on the heels of what Humana described as a strong second-quarter 2023, due in large part to "better-than-expected" membership growth in Medicare Advantage. The insurer collected earnings of about $956 million, a 37.8% increase over the $697 million it earned during the same period last year.

Revenue also showed a 13% improvement over Q2 2022, hitting $26.7 billion for the quarter. President and CEO Bruce Broussard said this figure outperformed market estimates.

Humana's Medicare Advantage numbers were somewhat surprising given the company's initial expectations. The insurer now expects that 2023 MA numbers will see an 18% increase over last year, with approximately 825,000 new members.

A June 16 filing with the Securities and Exchange Commission showed that this high utilization among its members was resulting in high benefit expenses, driven in part by strong MA membership growth during the open enrollment period, which included a higher-than-expected proportion of age-ins. They tend to run a higher benefit expense ratio than the average new member, Humana said.

Humana and UnitedHealthcare together account for 46% of all Medicare Advantage enrollees nationwide, according to KFF.

THE LARGER TREND

Earlier this year, 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" throughout this year and into next, and will shift more of its focus to government-funded programs and specialty businesses.

Following a strategic review, the company determined that the Employer Group Commercial Medical Products business was no longer positioned to "sustainably meet the needs of commercial members" over the long term or support the company's long-term strategic plans.

ON THE RECORD

"At Humana, we are committed to providing the highest levels of support and care for our members," said Humana Senior Vice President Carl Daley. "With millions of American adults currently living with chronic kidney disease, we continue to expand our programs, and this latest collaboration helps our members have access to value-based, coordinated chronic kidney disease care, as well as a vast amount of resources tailored to meet their specific needs throughout each stage of their healthcare journey."
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com