Humana’s Partnership With AdaptHealth Is Another Step Toward Value

Aug 17, 2023

In early May, Humana Inc. (NYSE: HUM) entered into an agreement with AdaptHealth Corp. (Nasdaq: AHCO), a home medical equipment (HME) provider. AdaptHealth will become the "capitated provider of durable HME and supplies" for at least one million Humana Medicare Advantage (MA) members in 33 states and the District of Columbia.

The partnership is a part of Humana's overarching home- and value-based long-term care strategy. Its network now includes one of the largest MA plans in the country, as well as one of the largest home health providers in CenterWell Home Health.

It has the two biggest pieces of the puzzle, and now it is attempting to build out the other parts that will help complete the goal of having a value-based structure for patients being cared for in the home.

AdaptHealth CEO Steve Griggs told Home Health Care News that he believes this will be the start of a larger value-based relationship with Humana.

"This is a starting point for value-based care," Griggs said. "As we do a good job with the capitated business, and the patient gets the care that Humana is expecting, then hopefully that will lead to us being able to do more with Humana. Their stated goal is to do more in the home, and the home right now is where they’re putting forth a lot of emphasis and a lot of attention."

The Pennsylvania-based AdaptHealth provides HME, medical supplies and other related services to approximately 3.9 million patients annually in all 50 states.

In addition to Humana's 5.6 million MA members, the company has onehome, a value- and risk-based integrated home-based care services platform.

On its health care services side, Humana has CenterWell Home Health, which provides care to more than 350,000 patients per year via its 352 locations. It also has CenterWell Senior Primary Care, which — together with its sister brand, Conviva Care Center — has 249 care centers across the country.

The two companies hope that the partnership will help eliminate "many of the burdens that patients face in ordering home medical equipment." Under value-based models, outcomes drive everything, which means patients having the necessary equipment is paramount.

From Humana's perspective, it also likely believes that a quality HME partner will help it hold onto its MA members.

"I think the big thing was simply understanding value-based care as it related to the DME provider from Humana's view," Dan Bunting, special advisor to the CEO at AdaptHealth, told HHCN. "What can we do that can help them keep their membership? We’re really both pushing to make sure that that member is getting the best service possible, specifically with that equipment in their home."

At the outset of the partnership's rollout, Humana and AdaptHealth are going to prioritize patients based on the severity of disease type. Bunting is confident that the data Humana has at its disposal will be of major help during that process.

Beginning on July 1, all new participating members will be using AdaptHealth as their HME provider. Though the companies are beginning a major project together, Bunting hopes that things will be up and running as they see fit in a relatively short amount of time.

"If we can succeed here – which we have full confidence that we will – then it just starts opening up all sorts of different doors," Griggs said. "Everybody knows more is going to happen in the home. That is going to be defined by not just the payers and not just us, but really the patients. Patients are going to be given more and more control of their health care, and we’re going to be in the position to help with that."

Dr. Andrew Agwunobi, the president of Humana's home solutions business, expressed the importance of getting all of these elements of the company's strategy together to HHCN earlier this month.

"Utilization management, network management, DME, etc., expanding that to as many of the Humana members as possible," Agwunobi said. "That is really important to us."

Ultimately, having those capabilities – whether in house or through partnerships – is what Humana believes will give it a leg up in a value-based health care world.

"I suspect that Humana's goal is to better coordinate everything going on in the home," Griggs said. "We will have to be coordinating our services and our products with their home health, their physician practice, their insurance to manage better coordination."

AdaptHealth, Humana Inc.

Before becoming a reporter, and then editor, for HHCN, Andrew received journalism degrees from the University of Iowa and Northwestern University. When he's not writing about health care, he makes himself miserable by indulging in Chicago sports.