Humana CEO: Medicare Advantage could fix what ‘Medicare for All’ tries to solve

Humana CEO Bruce Broussard doubled down on his support for Medicare Advantage (MA) when asked to discuss “Medicare-for-All” proposals Monday.

The leader of the Louisville, Kentucky-based insurance giant was addressing the Better Medicare Alliance Medicare Advantage Summit in D.C. when he was asked about his thoughts on the national conversation around Medicare for All and other public option proposals. He remained coy about outright discussion of any proposals but has previously avoided disavowing public option proposals like many of his counterparts at other insurers. He has said he opposes any move that would make MA or other private insurance plans illegal.

“When I think about where Medicare Advantage is, if we do our work the right way, I can see Medicare Advantage being the payment model that is being used where we want to fill that need where people don’t have an employer plan and they’re not being covered by Medicaid,” Broussard said. “I’m biased as hell. But I just think Medicare Advantage has all the elements, and how can we take that and bring that in line with other coverage, cost and quality.”

MA has become a big line of business for Humana as well as for other insurers. In May, Humana announced a strong start in the first quarter of 2019 driven by better-than-expected growth in MA plans. The company raised its full-year expected individual growth for MA to between 415,000 to 440,000 members, representing 14% growth in 2019.  Humana initially projected an increase of between 375,000 and 400,000 MA members for 2019.

Through MA, Humana members have reported 7% less emergency department visits and 5% fewer hospital stays. In addition, there has been an 11% lift in colorectal screenings and 10% more breast cancer screenings.

Home care evolution

Broussard also addressed why Humana has been focusing more of its business on care in the home.

Last July, Humana, along with TPG Capital and Welsh, Carson, Anderson & Stowe, completed the acquisition of Kindred Healthcare. Under the deal, initially announced in 2017, Kindred’s home health, hospice and community care businesses will be separated into a standalone business called Kindred at Home, 40% of which is owned by Humana.

“We see home [care] evolving in a few ways. We see home evolving first, moving from a therapy-based model that reimbursement has always oriented to therapy—and that’s really where the rewards were—to a nursing model where you can take care of a more expensive population—COPD, CHF, diabetes. This evolvement is, for one just around how you pay for it and pay for outcomes, not for procedures or for how many episodes you have. So you see the organization today, we’re in six states now, moving in that direction,” Broussard said.

Kindred has about 50,000 nurses that go into the home every day. Broussard said Humana looked at that as a “distribution channel” to be able to understand what’s going on in patients’ homes. He said the insurer is also expanding the reach of those nurses through telehealth.

“A nurse or a social worker in the home has so much influence on the individual’s care model,” Broussard said. “They have so much influence because it’s convenience, they see the holistic aspect of how an individual is living and they build a deeper relationship.”

https://www.fiercehealthcare.com/payer/humana-ceo-bruce-broussard-ma-could-fix-problems-medicare-for-all-trying-to-solve