New Study from Humana Healthcare Research and Harvard University Reveals Better Access to Primary Care for Seniors Receiving Care from Senior-Focused Primary Care Organizations

Rhea-AI Summary

Humana Inc. (NYSE: HUM) has published a groundbreaking study in Health Affairs, conducted with Harvard University, on senior-focused primary care. The study, analyzing data from over 462,000 Medicare Advantage patients, reveals that senior-focused primary care organizations provide better access to care compared to traditional fee-for-service models. Key findings include:

- 17% more primary care visits for patients in senior-focused care
- 39% more visits for Black beneficiaries and 21% more for low-income beneficiaries
- Potential improvements in cancer screenings, medication adherence, and chronic disease management

This value-based care model, tailored to older adults' needs, shows promise in reducing health disparities and improving overall health outcomes for seniors, particularly those with chronic conditions and complex needs.

Positive

• Study shows 17% increase in primary care visits for patients in senior-focused care organizations
• Significant improvement in care access for Black (39% more visits) and low-income (21% more visits) beneficiaries
• Potential better performance on quality measures including cancer screenings and medication adherence
• Possible reduction in hospital use for patients in senior-focused primary care organizations

Negative

• None.

Insights

Healthcare Policy Analyst

This study represents a significant shift in healthcare delivery for seniors. The 17% increase in primary care visits for patients in senior-focused organizations is substantial, potentially leading to better preventive care and chronic disease management. Even more striking is the 39% increase for Black beneficiaries and 21% for low-income beneficiaries, which could help address long-standing health disparities.

The value-based care model, supported by Medicare Advantage, allows for more comprehensive services tailored to seniors' needs. This aligns with the industry trend towards personalized, proactive care. However, it's important to note that while the study suggests improvements in quality measures and reduced hospital use, these findings require further research due to study limitations.

For Humana, this validates their investment in CenterWell and Conviva Care Center. It positions them favorably in the competitive Medicare Advantage market, potentially attracting more enrollees and healthcare partners.

Financial Analyst

This study could significantly impact Humana's market position and financial performance. By demonstrating the effectiveness of their senior-focused primary care model, Humana may attract more Medicare Advantage enrollees, potentially increasing revenue and market share. The improved access to care, especially for underserved populations, could lead to better health outcomes and potentially lower long-term healthcare costs for Humana.

Investors should note that this model requires substantial upfront investment in infrastructure and staff. However, if it results in reduced hospital use and better chronic disease management as suggested, it could improve Humana's profit margins in the long run. The company's expansion of CenterWell and Conviva Care Centers indicates confidence in this model's financial viability.

While promising, it's important to await further studies on quality measures and cost-effectiveness before drawing definitive conclusions about the model's long-term financial impact.

Public Health Expert

This study highlights a potential game-changer in addressing health disparities among seniors. The increased primary care visits, especially among Black and low-income beneficiaries, could lead to earlier detection and better management of chronic conditions, ultimately improving population health outcomes.

The senior-focused model's emphasis on longer appointments, same-day access and integrated care teams aligns with best practices in geriatric care. This holistic approach is particularly important for managing the complex health needs of older adults with multiple chronic conditions.

However, it's important to consider potential limitations. The study focuses on Medicare Advantage enrollees, who may not be representative of all seniors. Additionally, while increased access is promising, we need more robust evidence on how this translates to improved health outcomes and quality of life for seniors. Future research should also examine the model's scalability and potential implementation challenges in diverse healthcare settings.

In collaboration with a leading researcher and professor at Harvard University, Humana’s first-of-its-kind study found better access to primary care and narrowed racial and socio-economic disparities for those receiving care from senior-focused primary care organizations.

LOUISVILLE, Ky.--(BUSINESS WIRE)-- Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, recently published a study on senior-focused primary care — a value-based care model that tailors the environment and services of clinical organizations to the unique needs of older adults. Published in Health Affairs, this study is the first of its size and scope in analyzing this type of organization. This joint study, conducted in partnership with a leading researcher and professor at Harvard University, found better access to primary care for patients of senior-focused primary care organizations compared to other types of primary care organizations like the traditional fee-for-service model.

Humana Inc., one of the nation’s leading health and well-being companies, recently published a study on senior-focused primary care — a value-based care model that tailors the environment and services of clinical organizations to the unique needs of older adults. Published in Health Affairs, this study is the first of its size and scope in analyzing this type of organization. This joint study, conducted in partnership with a leading researcher and professor at Harvard University, found better access to primary care for patients of senior-focused primary care organizations compared to other types of primary care organizations like the traditional fee-for-service model. (Photo: Business Wire)

“We know that increasing access to primary care services is critical to our efforts to deliver better health outcomes for our patients,” said Dr. Kate Goodrich, Humana’s Chief Medical Officer. “This first-of-its-kind study shows that patients in senior-focused primary care organizations had better access to care, and that’s important because it informs our efforts to effectively address the needs of seniors, many of whom have chronic conditions and complex needs. Of note, it showed even larger benefits for Black and low-income patients, reducing health disparities. All those things are good news for our patients, and this study demonstrates that the senior-focused primary care model is working.”

Today’s primary care healthcare system often fails to meet the needs of seniors, many of whom have both chronic conditions and complex care needs. The traditional primary care system that primarily operates in fee-for-service arrangements with insurers can be difficult to access and is often more reactive than proactive. Alternatively, senior-focused primary care organizations operate within a value-based care model supported predominantly by population-based payment contracts with Medicare Advantage. This payment arrangement, enabled by current CMS payment policies, provides the infrastructure, flexibility, and financial incentives for senior-focused primary care organizations to provide tailored, holistic, coordinated, and proactive care to older adults, particularly historically underserved populations. Senior-focused primary care organizations offer longer appointment times, same-day appointments when needed and access to on-site teams of doctors, nurses, pharmacists, social workers, behavioral health specialists and referral specialists who provide a wide range of extended services to meet the comprehensive needs of seniors.

In collaboration with a leading researcher and professor at Harvard University, the Humana Healthcare Research team analyzed data across six different senior-focused primary care organizations and on more than 462,000 patients enrolled in Medicare Advantage in 2021 to compare healthcare service use and quality of care between those that were and were not patients of senior-focused primary care organizations. The main takeaways validate primary care providers’ long-term investment in integrated senior care services, including for example, Humana’s owned senior-focused primary care brands, CenterWell Senior Primary Care and Conviva Care Center.

Relative to more traditional primary care settings, patients of value-based, senior-focused primary care organizations had 17% more primary care visits, with larger differences among Black and low-income beneficiaries. Senior-focused primary care organizations served more Black and low-income beneficiaries than other primary care settings, and these patients had 39% and 21% more primary care visits, respectively, than Black and low-income beneficiaries in other primary care settings, helping to reduce health disparities. Findings from the study also suggest that patients of senior-focused primary care organizations might experience better performance on several quality measures, including recommended cancer screenings, medication adherence, controlled blood pressure and diabetes, and less hospital use, but due to study design limitations more research is needed on these outcomes.

"This study bears out what we see day-to-day in our approximately 300 centers, many of them located in underserved areas,” said Reneé Buckingham, president of Humana’s senior-focused primary care organization. “Focusing on seniors in a value-based, team-oriented care model means that we can spend more time with patients, understanding the many social and other factors that play a role in overall health. It’s that deep knowledge of our patients that drives these better outcomes. In fact, this data proves what we’ve known for some time – senior-focused primary care improves well-being so those under our care can attain their best health and live their lives to the fullest. Increasing access to senior-focused primary care is an important lever in delivering better health outcomes for our members and patients.”

You can access the full study on the Health Affairs website.

About Humana

Humana Inc. is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell health care services, we strive to make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240904301644/en/

Sara Nelson

Humana Corporate Communications

Snelson31@humana.com



Kevin Smith

Humana Corporate Communications

Ksmith305@humana.com

Source: Humana Inc.

FAQ

What did Humana's study with Harvard University reveal about senior-focused primary care?

The study revealed that senior-focused primary care organizations provide better access to care compared to traditional models, with 17% more primary care visits overall and even larger increases for Black and low-income beneficiaries.

How does senior-focused primary care impact health disparities according to Humana's study?

The study found that senior-focused primary care organizations helped reduce health disparities by providing 39% more primary care visits for Black beneficiaries and 21% more for low-income beneficiaries compared to other primary care settings.

What potential quality improvements were observed in Humana's senior-focused primary care study?

The study suggested potential improvements in cancer screenings, medication adherence, controlled blood pressure and diabetes management, and reduced hospital use for patients in senior-focused primary care organizations, though more research is needed to confirm these outcomes.

How many patients were included in Humana's study on senior-focused primary care?

The study analyzed data from more than 462,000 patients enrolled in Medicare Advantage in 2021, comparing healthcare service use and quality of care between those in senior-focused primary care organizations and those in other settings.