When industry insiders think about Humana Inc. (NYSE: HUM) and its home health plans, they immediately go to Kindred at Home, the large provider that’s rebranding to “CenterWell Home Health.”
Yet onehome, a home-focused post-acute care organization that operates under a full-risk model, is just as important to the Louisville, Kentucky-based health insurer’s in-home care strategy. On Thursday, Humana announced it’s bringing the onehome platform to the new market of Virginia as part of a steady expansion push.
“Humana’s acquisition of onehome in 2021 and expansion into Virginia this year further advances the company’s commitment to building our Home Solutions business and value-based offerings,” Dr. Andrew Agwunobi, president of Humana’s home-based care segment, said in a press release. “There is a tremendous need for a care model that provides high quality, fully-integrated care in the home at reduced cost.”
Humana was already leveraging onehome’s capabilities to coordinate value-based care in the home in Florida and Texas. In addition to home health care, onehome also manages services like durable medical equipment (DME) and home infusion.
Dr. Joe Mayer is the president of onehome and one of its founding leaders. Formerly a physician at Mount Sinai Medical Center in New York and the founder of health care IT company Cureatr, Mayer partnered with the PE company WayPoint Capital Partners to build “a new kind of post-acute care provider” back in 2018.
That mission led to the takeover of onehome, which, at the time, was a four-year-old company. Mayer and his team have since worked to shape the business into the provider-convener platform it is today.
“Rather than being what I would call a middleman – managing a network, doing utilization management, re-contracting with national providers – we are a vertically integrated provider,” Mayer told Home Health Care News in April 2021. “We’ve got our own home health agencies, our own 40,000-square-foot DME warehouse in the markets we’re in. We’ve got our own fleet of vehicles. We’ve got our own pharmacies.”
In Virginia – and in other markets moving forward – onehome will effectively become a major home-based care hub for Humana members.
“onehome’s integrated model creates a single point of accountability that takes into account the
needs of patients, physicians, hospitals and health plans for home-based patient care, with that care largely delivered through a network of local home care providers,” the press release explains.
Initially, onehome’s value-based model is rolling out in Richmond, Roanoke and across other counties in Southern Virginia. Within “several months,” onehome will be available to coordinate home-based care services for Humana Medicare Advantage (MA) plan members throughout the state, as well as in North Carolina.
In the future, services will be payer agnostic, with onehome working with MA plans in Virginia and North Carolina other than Humana. With this expansion, Humana plans to add about 220 employees in Virginia and North Carolina by the end of 2022, bringing the company’s total employment in the region to more than 2,000.
Humana CFO Susan Diamond, who previously led the company’s home-based care segment, outlined some of those plans a day before the onehome announcement.
“We’ve got … mature and well-established value-based arrangements on the primary care side. I would say in the home space, that’s the next one we’re very excited about,” Diamond said at the Jefferies Healthcare Conference in New York Wednesday. “We do have a belief that more care will be delivered in the home over time – because consumers would prefer it, and technology and other enablements will make that possible.”
Within five years, Humana expects 50% of its MA members to have access to its value-based in-home care model, the CFO noted, emphasizing the role onehome plays.
“The way that model works is, we contract with onehome on a capitated basis for home health, DME and infusion, and they’re responsible for managing that spend down,” Diamond said. “They do that quite effectively today. They act as a convener and take hold of that authorization that comes in, then take care of actually referring to all of those services.”
Additionally, onehome allows Humana to also direct members to high-quality providers, including Kindred at Home or CenterWell, which drives a greater degree of penetration than the insurer could otherwise.
“We’re getting ready to expand that,” Diamond continued. “We will continue to bring clinical innovation to that.”
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