Picture: Raymond Gehman/Getty Pictures
Main insurer Humana has partnered with multi-speciality group observe Kelsey-Seybold Clinic, signing an in-network settlement that Humana hopes will enable expanded entry to value-based care, by way of a broadening of its Medicare Benefit supplier community within the Houston space.
The insurer expects the transfer will increase entry to care to incorporate members of its Medicare Benefit HMO plans.
Beneath this settlement, which turns into efficient January 1, 2022, Houston-area members of Humana Medicare Benefit HMO plans could have in-network entry to care at greater than 26 handy Kelsey-Seybold Clinic places, in addition to entry to greater than 500 suppliers in 55 medical specialties throughout the Houston-Galveston area.
WHAT’S THE IMPACT
Members of the MA HMO plans could have entry to Kelsey-Seybold’s coordinated well being companies, with a number of specialties enhanced by superior applied sciences, together with digital medical file techniques, which try to eradicate duplicate medical testing.
Humana has burdened that the brand new relationship will emphasize the insurer’s concentrate on value-based care, which incorporates extra private time with well being professionals and customized care, in addition to entry to proactive well being screenings and packages targeted on stopping sickness.
The insurer has additionally promised to leverage applied sciences reminiscent of information analytics to attach physicians and facilitate coordination of care. It has additionally pledged reimbursement to physicians that’s linked to well being outcomes, quite than the fee-for-service mannequin of reimbursement based mostly on amount of companies.
Humana has additionally stated it expects improved take care of individuals residing with persistent circumstances.
THE LARGER TREND
The yr has been a busy one for Humana by way of pursuing partnerships with varied organizations. In June, the insurer signaled its intent to accumulate One Homecare Options, or onehome, in an effort to develop its presence within the value-based dwelling healthcare area. Monetary phrases of the deal weren’t disclosed, although the insurer expects it is not going to have a major impression on its financials for the yr.
In July, Humana and Signify Well being started working along with the Alamo Space Neighborhood Community to assist Humana Medicare Benefit members in San Antonio by way of AACN’s group sources and by connecting these in want with health-related social companies reminiscent of meals, transportation, housing and monetary help. It marked the newest effort in Humana’s six-year Daring Aim marketing campaign to handle health-related social wants.
Additionally in July, Anthem, Humana and SS&C Applied sciences entered right into a three way partnership named DomaniRx to develop a claims adjudication and pharmacy advantages supervisor cloud platform, in accordance with paperwork filed by SS&C Applied sciences with the Securities and Alternate Fee. SS&C Applied sciences holds an 80.2% curiosity, and Humana and Anthem every maintain a minority curiosity, in accordance with the settlement filed with the SEC on July 15.
Humana logged a web revenue of $588 million in the course of the second quarter.. And whereas that is significantly lower than the $1.8 billion posted a yr in the past at the moment, when sufferers have been deferring care, it nonetheless beat expectations thanks largely to falling COVID-19 therapy prices for its members.
Humana additionally stated that “strong fundamentals” throughout its enterprise strains have performed a component, particularly as the corporate continues to navigate the impacts of the coronavirus pandemic.
ON THE RECORD
“Kelsey-Seybold Clinic, each well-known and revered within the Larger Houston space, has a longtime historical past of offering high quality and coordinated healthcare to sufferers,” stated Invoice White, Texas Medicare President, Humana. “This can be a main growth for Humana in Houston, and we’re grateful to have the ability to provide our Humana Medicare Benefit HMO members a further prime quality healthcare choice as we regularly work to assist make it simpler for our members to realize and preserve their finest well being.”
“Offering prime quality, coordinated take care of these residing within the Houston-Galveston area is what Kelsey-Seybold Clinic is understood for, and what we’re most happy with,” stated Kenneth Janis, chief working officer, Kelsey-Seybold Clinic. “Increasing entry to take care of Medicare eligible sufferers on this area is a crucial step in bettering the well being and wellness of all Houston and surrounding space residents and we sit up for welcoming their members at our clinics.”