4/30/21 Weekly Update
Summarizing the week that was in the business of healthcare
Welcome to The Donut Hole’s weekly summary. The news doesn’t stop. Lucky for you, we are here to help you take in the week that was in the business of healthcare.
Humana to buy out remaining stake in Kindred for $5.7B
The home care market has been incredibly active with large funding rounds for start-ups and lots of acquisition activity. Just this week, for example, Anthem closed its purchase of MyNEXUS, a home care benefits manager. This article focuses on Humana acquiring the 60% interest in Kindred at Home that it didn’t already own from private equity firms TPG Capital and Welsh, Carson, Anderson & Stowe (WCAS). Per the company’s press release, Kindred has 43K caregivers and provides home health, hospice, and community care services to over 550K patients annually. The press release commentary highlighted Kindred’s role in value-based care models and clinical capabilities ranging from preventive services to higher acuity, emergent, hospital-level care.
Bruce Broussard, Humana’s CEO, commented:
“Fully integrating Kindred at Home will enable us to more closely align incentives to focus on improving patient outcomes and on reducing the total cost of care. This is critical to deploying at scale a value-based, advanced home health model that makes it easier for patients and providers to benefit from our full continuum of home-based capabilities, leveraging the best channel to deliver the right care needed at the right time.”
Susan Diamond, President of Humana’s Home Care business unit, noted:
“Kindred at Home continues to demonstrate superior patient outcomes, including reduced hospitalizations, readmissions, and ER utilization even as their penetration of Humana episodes increased from 8 percent to 19 percent in markets with geographic overlap.”
Potential impact on you: As we’ve noted in nearly all weekly updates, value-based payment models are the future of American healthcare. A key component to value-based models, especially around acute care and treatment of expensive chronic conditions, is shifting more care out of the hospital to lower cost settings, particularly the home. Kindred and others have proven that home care can improve quality and lower costs, and the largest payors and providers have taken note.
CVS adding 14 new markets to its Project Health preventive screening program
CVS Health is expanding its program to offer no-cost, community-based screenings to 14 additional markets. The program, named Project Health, offers free biometric screening, including blood pressure, glucose levels, and cholesterol, at CVS Pharmacy locations. Patients can then meet with a nurse practitioner who can provide additional guidance and referrals for follow-up care. The goal of the program is to proactively identify and treat disease before conditions worsen, especially within historically underserved populations.
Potential impact on you: While this isn’t the sexiest program, it’s a good reminder of how our historical fee-for-service system, which has little incentive to invest in broadly accessible preventative services, fails patients and leads to higher overall costs. Programs like CVS’ are key to better managing chronic diseases and lowering costs by preventing downstream hospitalizations and expensive complications. As more money flows into value-based primary care models, expect to see more of these proactive programs.
It’s also encouraging to see resources flowing into underserved communities to help address longstanding gaps in care access and care quality.
Lowering Medicare's eligibility could lead to reduced costs for employer sponsored plans: KFF
Here’s some news from the policy world. The Kaiser Family Foundation released two analyses centering on lowering Medicare eligibility from age 65 to 60. One analysis looked at the savings for employer-sponsored plans and another examined the savings for those 60 to 64 who would be shifted onto Medicare. KFF concluded that shifting these populations to Medicare would result in significant savings for employer-sponsored plans - 15% savings if those 60-64 and 30% savings if those 55 and older were moved to Medicare. Moreover, many of these patients would save money themselves by shifting from private health plans to Medicare via lower deductibles and co-pays.
Reducing the Medicare eligibility age is a priority for many Congressional Democrats but it remains unclear if the Biden administration will push for it.
Potential impact on you: Lowering the Medicare eligibility age would decrease healthcare spending as Medicare pays lower rates to providers and drug manufacturers than private plans do. While that may be good for individuals and society at large, it would likely result in reduced health system revenues and lower provider compensation. There are always trade-offs!
Other news you may like:
Amwell rolls out new telehealth platform that integrates with digital health tools
Columbia researchers develop kidney disease-spotting algorithm
Sanford Health builds EHR templates in Epic to eliminate note bloat
Cigna to offer Ginger's behavioral health platform as in-network benefit
Have a great weekend!
— Hannah and Caleb Bank, Co-founders
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