Value-based care has been popular in primary care for quite some time, but despite much conversation, many home health organizations have been reluctant to adopt value-based models.
Within Humana Home Solutions, we believe strongly in a value-based future and are actively working to pioneer and prove the concept.
As President of Humana Home Solutions and CenterWell Home Health, I’ve witnessed home health care evolve rapidly in recent years, marking a departure from its traditional roots, with a growing emphasis on holistic and coordinated health care in the home. The value-based care model shows great potential to further this transformation by prioritizing patient outcomes over the volume of services provided and ensuring a more flexible, personalized and effective approach to care.
With our new value-based care model, Humana and its CenterWell Home Health unit are aligning with today’s focus on individualized, patient-centered services. An advantage of this approach is enhanced collaboration between physicians and home health providers, which we believe can improve care coordination and outcomes. In fact, early indications from our in-home value-based care efforts show a reduction in hospitalizations and success in keeping seniors healthy and at home—where they prefer to be.
As we continue to refine and expand our approach, the benefits for both patients and health care providers become increasingly clear, laying the foundation for a more collaborative and efficient future in home health care.
A Promising Approach
Under the traditional home-health model, patients who require care after hospitalization are discharged to receive home health care in episodes of 30-60 days. This model is designed for patients who have an active relationship with a primary care physician (PCP) who oversees their in-home care through a delegated model.
Under our new value-based model, our clinicians closely coordinate home-based health services alongside Humana’s senior-focused Primary Care Organization (PCO) and our OneHome subsidiary, which streamlines the care process, reducing complexity and enhancing care delivery. In a best-case scenario, both hospital readmissions and skilled nursing facility stays are reduced.
In practice, our PCO physicians act as “quarterbacks” for patients, directly connecting them with home health providers who carry out the orders of the physician in ensuring timely and effective care. In some cases, patients can enter in-home care not from a hospital, but through referrals from their PCP. For those who don’t need long episodes of care, patients may receive in-home care for as little as a week or two – just long enough to stabilize them until they gain a safe level of independence. By aligning our services with Humana’s primary care network, we provide a streamlined experience that benefits both patients and providers.
Typically when someone is in a hospital, their care is ordered by the hospitalists who treated them in the hospital, but do not have an ongoing relationship. They face significant challenges in managing post-discharge care. While they often order care for patients, they are not following the patient throughout the duration of the care journey but instead are specifically tied to the hospital. Unfortunately, patients who don’t have a PCP relationship are often discharged to skilled nursing facilities. This is where the CenterWell team can help, collaborating with the hospitalist to review the orders and developing a comprehensive home care plan with a Humana PCO physician to ensure there’s always a doctor overseeing the care. This doctor will stay engaged with the patient even after their home care is ended.
Our multidisciplinary approach tailors care to each patient’s unique needs, involving nurses, physical and occupational therapists, speech pathologists, and social workers, as well as addressing social determinants of health (SDoH) that might impact recovery, such as food insecurity or housing challenges.
A key component of this model is a commitment to continuous communication and real-time updates. With advanced technology providing data-driven insights and remote monitoring, hospitalists are kept fully informed about their patients’ progress at home. This connectivity fosters better care coordination, reducing fragmentation between hospital care, home health and primary care services. As a result, hospitalists can have greater confidence that their patients are receiving high-quality, consistent care that supports successful recovery and lowers the risk of readmission.
The Future of Value-Based in-Home Health Care
Our value-based model serves as a blueprint for future arrangements between health plans and home health providers. However, we know that there is still work to be done in proving the benefits of this model, which is why we aim to provide value-based, in-home health care to 80,000 home health patients to track the data on outcomes and readmissions on a larger scale.
Our confidence in expanding this model underscores its capacity to improve both payment mechanisms and care quality. With a substantial sample size to validate our approach, we are in a strong position to demonstrate the importance of value-based home health care. As we continue to lead by example, we hope to inspire other providers to adopt similar models, ultimately benefiting patients and enhancing the overall quality of home health care.
By working together, we can set a new standard of care that improves patient outcomes and drives the industry forward.
If you are interested in learning how CenterWell Home Health can support your patients and practice, visit CenterWellHomeHealth.com.
Kirk Allen, President of Humana Home Solutions and CenterWell Home Health