Humana partners with in-home provider for 24/7 care

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Humana has partnered with in-home service provider DispatchHealth to offer in-home emergency and acute care to its 8.4 million Medicare members, as demand for out-of-office treatment rises during the COVID-19 pandemic, particularly among those living with chronic conditions.

The Louisville, Ken.-based insurer will immediately roll out DispatchHealth’s services to enrollees in Denver, Colo. and Tacoma, Wash., with plans to expand to cities in Texas, Arizona, and Nevada by the end of the year. The Denver, Colo.-based home healthcare provider offers patients 24/7 remote monitoring by an internal medicine physician specialized in ER training, a physician’s assistant and a nurse practitioner, along with daily visits from providers, including bedside nursing.

Susan Diamond, president of Humana’s Home Business, said the agreement makes Humana the country’s first national payer to provide acute, hospital-level care in the home. She said the insurer and Dispatch started talking in mid-2019, a year after the company paid $4.1 billion to acquire Kindred, the nation’s largest provider of in-home care, and a year before the COVID-19 pandemic shifted consumer and healthcare professionals’ perspectives on outpatient treatment.

“There’s been greater adoption of virtual medicine, both with patients as well as within the physician community,” Diamond said. “We saw significant increases in the delivery of virtual medicine, more so than anywhere within our physician and specialist communities—not the traditional Teledoc’s and those sort of on-demand, one-time services.”

Diamond said Humana conducts about 550,000 home health visits each year, Diamond said. With DispatchHealth, Humana aims to grow the amount of in-home treatment it provides and reduce the overall cost of care by continuously monitoring members’ health and catching patient incidents before they require costly, in-patient treatment. Dispatch’s model also relieves the emotional burden faced by families since, “oftentimes, it’s challenging for families to make the decision to return home once they’ve already entered a facility,” Diamond said.

Unlike most in-home care providers, Diamond said DispatchHealth partners with hospital systems, physicians and patients directly, rather than waiting to refer patients after they visit an emergency room. About 16% of patients admitted to emergency rooms ultimately return, Diamond said.

“We’re going to see fewer readmissions and less post-acute care because Dispatch will really take a 30-day episode of care approach and provide more care than you’d see in just a traditional facility-based setting,” Diamond said.

Right now, Humana will pay DispatchHealth on a fee-for-service basis but eventually aims to transition to a value-based relationship. The company will start by offering this service to its Medicare members, although Diamond ultimately seeks to scale this service to its 16.8 million total enrollees, including Medicaid and commercial members too.

She noted that DispatchHealth got its start providing house calls for individuals on Medicaid. Since launching in 2013, DispatchHealth says it has cared for more than 220,000 patients at home and saved over $227 million in medical costs.

In addition to meeting beneficiaries’ medical needs, DispatchHealth said it can address the social determinants of health, like food insecurity, social isolation and housing instability. The company can also coordinate members’ pharmacy deliveries, offer physical and respiratory therapy, imaging services and more.

Lili Brillstein, CEO of the BCollaborative value-based care consultancy and former director at UnitedHealth Group and Horizon Blue Cross Blue Shield of New Jersey, said it makes sense that Humana was the first to launch an at-home acute care service since the provider boasts the greatest number of Medicare Advantage members in the nation.

In addition to reducing costs by managing enrollees’ chronic conditions, Brillstein said the partnership will provide another avenue for individuals to see a doctor outside the hospital. At the end of the company’s most recent third-quarter on Sept. 30, Humana reported $1.3 billion in net income, a more than 94.5% increase year-over-year driven by historically low utilization among its members.

“They’re solving for exactly that issue for people either being too afraid or just not able to access medical care, so they’re bringing it into the home,” Brillstein said.

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