Humana’s Focus on Annual Wellness Visits for Medicare Advantage Profitability
A central theme in Humana’s plan for boosting Medicare Advantage profitability in the future is a strategy its peers have relied on for over a decade: coaxing members in for their annual wellness visits.
The Medicare Advantage business has come under scrutiny in recent months for its impact on the federal budget, leading to discussions on limiting insurers’ tactics for maximizing government payments. However, Humana remains optimistic about the potential for profitability in the private form of Medicare for older adults, emphasizing the importance of doubling down on proven strategies.
At a recent investor day in Louisville, Ky., George Renaudin, the president of Humana’s insurance business, highlighted the value of annual wellness visits for members. He emphasized that these visits, especially the at-home visits, are well-received by seniors who appreciate the convenience and personalized attention they receive to discuss their health conditions in the comfort of their own homes.
While the annual wellness visit was intended to allow doctors to assess patients’ health comprehensively, insurers often use these visits to add lucrative diagnosis codes, leading to higher government payments for sicker patients on paper. Humana is focusing on increasing annual wellness visits through innovative partnerships with its primary care subsidiary and embedding clinical insights into providers’ workflow systems.
Lisa Stephens, the chief operating officer of Humana’s insurance division, outlined a comprehensive approach to meeting the company’s goal of boosting annual wellness visits. This includes incorporating the visits into various touchpoints with members, such as call center interactions, to ensure that members are getting the care they need.
Humana’s CEO, Jim Rechtin, emphasized the company’s commitment to not only being a health insurer but also a senior services business. With a focus on returning the company’s Medicare margin to a sustainable level, Humana is prioritizing accurate diagnoses, follow-up care, and improved clinical outcomes to lower expenses. Rechtin emphasized the importance of managing growth with retention, as retaining customers over multiple years allows for a more significant impact on their care and drives the business forward.
In conclusion, Humana’s strategy for enhancing Medicare Advantage profitability centers on increasing annual wellness visits and delivering quality care to members. By focusing on engagement, accurate diagnoses, and improved outcomes, the company aims to ensure long-term success in the Medicare Advantage market.
