Humana

Health Care Executives Share Provocative Takes on the Future of Home-Based Care

Two weeks ago, Home Health Care News hosted our flagship FUTURE Conference in downtown Chicago. Since then, I’ve been reflecting on the event’s panels as well as my on-background conversations to get a better feel for where the health care world — and home-based care, in particular — is headed. Value-based care and the shift …

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Cohere Health, Humana Expand Partnership to Transform Prior Authorization Process

What You Should Know:  – Cohere Health announced that Humana Inc. is embarking on a nationwide expansion of Cohere’s digital prior authorization platform for musculoskeletal (MSK) services, based on the success of its initial implementation.  – After rolling out the platform across 12 states in January 2021, Humana has made significant progress toward achieving its …

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Humana Executive: Data, Analytics Key to a Home-Focused Health Care System

Home health operators have been advocating for more care to be delivered in the home for years. Those calls have now come to fruition. In actuality, other health care stakeholders have sought to shift more care into the home as well, but operational hurdles and unavoidable gaps in care made that mission seemingly impossible. But …

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Transactions: Trive Capital Invests in Choice Health at Home; LHC Group Completes Heart of Hospice Deal

Trive Capital, a Dallas-based private equity firm, has formed a partnership with Choice Health at Home. Tyler, Texas-based Choice is a home health, hospice and rehabilitation services provider. The company operates in 40 total locations across Texas, Louisiana and Oklahoma, with over 800 licensed health care employees. Sign up for HHCN + to read this …

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INVEST Digital Health preview: What’s the recipe for a successful social determinants program?

SDoH is just one of the topics at the MedCity INVEST Digital Health conference, a virtual event scheduled for September 20-23, in collaboration with Medical Alley.

Humana Sets Stage for Kindred Takeover, Remains Hopeful About a 2022 Return to Normalcy

Despite still reeling from COVID-19-related headwinds, Humana Inc. (NYSE: HUM) experienced better-than-expected results in its home and provider businesses during the second quarter of 2021. “Our strong operating performance this year is, in part, attributed to our strong partnerships with providers who are delivering high-quality care to our members,” Bruce Broussard, president and CEO of …

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Changemakers: Susan Diamond, CFO, Humana

Humana Inc. (NYSE: HUM) is hoping to disrupt the traditional home health model by combining a nationally scaled payer with similarly large provider. Among the executives leading that charge is CFO Susan Diamond. Humana named Diamond as its permanent chief financial officer on June 28. Prior to that appointment, she dually served as interim CFO …

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Recent Deals Signal Start of a New Home Health Arms Race, Market Shift

If you dig into the home health market, you’ll find that a lot of providers look very much alike. Overall, the home health market is made up of several thousand different players, from smaller mom-and-pop shops led by mission-driven nurses to multi-million-dollar behemoths led by savvy health care veterans. Yet for the most part, many …

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FirstLight Announces New President; Humana Home Care Leader Named CFO

McAnanly takes over at FirstLight FirstLight Home Care announced Wednesday that it has picked its new president. The appointment comes roughly seven months after FirstLight’s board of directors sought a change in leadership from former CEO Jeff Bevis, who founded the home care company with his son in 2009. Moving forward, the Cincinnati-based FirstLight will …

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Pennant Acquires First Call Hospice; Humana Grows CenterWell Footprint

Pennant adds end-of-life care provider The Pennant Group Inc. (PNTG) has acquired the assets of First Call Hospice, an end-of-life care provider that operates in Sacramento, California. Financial terms of the acquisition, effective June 16, were not disclosed. The Eagle, Idaho-based Pennant is the parent organization of a group of affiliated home health, hospice, home …

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Humana Acquires Integrated Post-Acute Care Provider onehome – M&A

What You Should Know: – Humana Inc. announced that it has signed a definitive agreement to acquire integrated post-acute care provider One Homecare Solutions (“onehome”) from WayPoint Capital Partners (WayPoint), the private equity affiliate of a New York-based family investment office. – The acquisition will further advance Humana’s strategy to build a value-based home health …

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Home Health Providers to Watch in 2021

The COVID-19 pandemic delayed the ambitious plans of most home health providers. Now nearly halfway into 2021, many are picking up right where they left off, with a few key players doubling down on innovation and betting big on the future of home-based care. There are plenty “home health providers to watch” as the rest …

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Why Humana Believes It Can Do Home Health Care Better

Humana Inc. (NYSE: HUM) believes it can deliver home health services better than traditional providers do today. More than any other reason, that’s fundamentally why it’s accelerating its in-home care strategy by acquiring 100% of home health giant Kindred at Home for a “bargain” purchase price of $5.7 billion — the company’s largest acquisition ever. …

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Humana to Acquire All of Kindred at Home, Divest Hospice and Community Care Operations

When Humana Inc. (NYSE: HUM) teamed up with private equity giants TPG Capital and Welsh, Carson, Anderson & Stowe (WCAS) to acquire Kindred Healthcare in July 2018, it was only a matter of time before the Louisville, Kentucky-based health insurer went off on its own. That time has finally arrived. As part of that $4.1 …

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What Medicare Advantage Plans Want From Home-Based Care Providers

Medicare Advantage (MA) has provided tailwinds for home-based care providers, as the overall MA member population has grown substantially over the last decade. In 2020, there were over 24 million MA members in the U.S., over double the amount there were in 2010 and nearly five times the amount in 2005, according to Centers for …

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Cohere Health Raises $36M to Automate Prior Authorization Between Payers & Providers

What You Should Know: – Boston-based health IT company Cohere Health has closed a $36 million Series B funding round led by Polaris Partners, with additional participation from new investors Longitude Capital and Deerfield Management, as well as existing investors Flare Capital Partners and Define Ventures. The round comes less than a year after the company launched, and only 3 months after …

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Epic-Humana partnership enters new phase focused on prior authorizations

The partnership between the insurer and EHR giant — announced a year and a half ago — will now focus on streamlining prior authorizations and offering providers enhanced insights about their patients. Ochsner Health will be among the first to implement the new capabilities offered by the companies.

Home Business President Susan Diamond to Serve as Humana’s Interim CFO

Susan Diamond — the Humana Inc. (NYSE: HUM) executive who has been in charge of building the health insurer’s vast home-based care infrastructure — is taking on an additional role. The Louisville, Kentucky-based company announced Monday that Diamond will be moving into the interim CFO role, effective June 1. Current CFO Brian Kane is stepping …

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Strive Health Raises $140M for Value-Based Kidney Care Platform

What You Should Know: – Strive Health, a Denver-based provider of value-based kidney care today announced $140 million in Series B funding with Alphabet’s independent growth fund, CapitalG, as the lead investor. Strive has more than doubled its presence in regional markets and grown its employee base by more than 600% in the last year. This funding will further increase that momentum.  …

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Unite Us Nabs $150M, Reaching $1.6B Valuation to Address Social Determinants of Health

What You Should Know: –   Unite Us, the tech company creating coordinated care networks nationwide, has just announced a $150M Series C round of funding led by ICONIQ Capital, bringing its valuation at $1.65 billion.   – Unite Us is leading the care transformation movement towards whole-person health with its core product, Unite Us Platform, an outcome-focused coordination software sconnecting community-based …

Unite Us Nabs $150M, Reaching $1.6B Valuation to Address Social Determinants of Health Read More »

After Building In-Home Primary Care Powerhouse, Heal CEO Steps Down

Less than a decade ago, Heal co-founder Nick Desai would regularly drive around Los Angeles with his wife and business partner, Dr. Renee Dua, carrying out their very first house calls. Since then, Desai has helped grow Heal into an in-home primary care powerhouse that has raised roughly $164.1 million since launching, including $100 million …

After Building In-Home Primary Care Powerhouse, Heal CEO Steps Down Read More »

DispatchHealth Raises $200M to Expand In-Home Medical Care Model

With a new round of financing secured, in-home medical care company DispatchHealth is gearing up for another major expansion push. The Denver, Colorado-based company announced Wednesday that it has raised an additional $200 million in Series D, bringing its overall fundraising total to more than $417 million since launching in 2013. DispatchHealth’s latest funding comes …

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Payers Increasingly Turning to Home-Based Care to Shoulder COVID-19 Costs

Back in 2018, it felt like the health care sector was on the verge of a massive shift, driven by a desire from payers to better manage their members’ total cost of care with enhanced in-home capabilities. Much of that feeling came from watching Humana Inc. (NYSE: HUM). The Louisville, Kentucky-based health insurer teamed up …

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Humana, IBM Watson Health team up to provide access to AI chatbot

Through a new collaboration, Humana’s Employer Group members will gain access to IBM Watson Health’s AI-powered digital assistant. The chatbot will provide information on member benefits, claims, referrals and cost estimates for medical services.

Humana Taps DispatchHealth to Power Hospital-Level Care in the Home

What You Should Know: – Humana Inc. and DispatchHealth, a provider of in-home medical care, today announced an agreement to provide Humana members with access to an advanced level of care in the home – to help enhance patients’ experience and health outcomes. The Dispatch-Humana agreement is believed to be the country’s first program to …

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AccentCare Announces New COO; Humana Names First Chief Health Equity Officer

AccentCare appoints Chris Dimos as COO AccentCare has named Chris Dimos its chief operating officer. Dallas-based AccentCare has over 200 locations across the U.S. As a company, it provides skilled home health and personal care services, along with hospice care, private-duty nursing and care management services. Prior to joining AccentCare, Dimos was the president of …

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Humana Taps Vida Health to Power Virtual Diabetes Management for Kentucky’s Medicaid Population

What You Should Know: –  Humana Healthy Horizons™ in Kentucky announced it has selected Vida Health’s virtual diabetes management program to serve Kentucky’s Medicaid population. – Vida’s diabetes management program achieves lasting results for participants. Because chronic conditions like diabetes, obesity, and hypertension often occur simultaneously, Vida’s unique program was built from the ground up to …

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Why healthcare orgs are joining an effort to create 1M jobs for Black Americans

The newly created organization, dubbed OneTen, aims to create 1 million jobs for Black people over the next decade. Its founders include some big names in healthcare, such as Cleveland Clinic, Intermountain Healthcare and Humana.

Home Health Executive Forecast for 2021: Reserving a Seat at the Big Kids’ Table

Going into 2020, many home health executives predicted that the Patient-Driven Groupings Model (PDGM) would kick off a wave of consolidation and agency closures. Others believed the phase out of Requests for Anticipated Payment (RAPs) would have a similar effect. For the most part, that didn’t happen. The COVID-19 pandemic — and all the policy …

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COVID-19: How Can Payers Prepare for Mandates and Support Pandemic Relief Efforts

Elizabeth Bierbower, Former President of Humana’s Group & Specialty Division Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest costs. Cost-sharing and insurance premiums are rising consistently since the …

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#Healthin2Point00, Episode 166 | $100 million, scandal, & more

Today on Health in 2 Point 00, we have scandal, drama, intrigue, $100 million and murder! Wait, no; not murder. On Episode 166, we catch up on more deals before Jess gets carried away again. The $100 million goes to Carbon Health in a Series C, which is another Bay Area-based primary care startup; they’re …

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Buoy Health Raises $37.5M to Expand AI-Powered Healthcare Navigation Platform

What You Should Know: – Buoy Health raises $37.5 million in Series C funding to expand it’s AI-powered healthcare navigation platform, bringing its total raised to date at $66.5M. – Buoy will use the proceeds to further build out its IP with respect to artificial intelligence and other technologies, as well as grow the Buoy …

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Humana Accelerates Value-Based Care Strategy with Home Health Providers, Others

Humana Inc. (NYSE: HUM) continues to shift its operations toward value-based care payment models, both with internal service lines and with external provider partnerships. The Louisville, Kentucky-based insurance giant is also doubling down on social determinants of health at the same time. Those are just a couple key takeaways from a Tuesday conference call with …

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Humana Taps Cohere Health to Modernize Prior Authorizations for Musculoskeletal Treatment

What You Should Know: – Cohere Health partners with health insurer Humana to modernize the prior authorization process for musculoskeletal treatment across 12 states. – In addition, the company has closed an additional $10M in funding led by Flare Capital Partners and Define Venture, bringing the company’s total funding to $20M. Health insurer Humana has …

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Value-based care – no progress since 1997?

By MATTHEW HOLT Humana is out with a report saying that its Medicare Advantage members who are covered by value-based care (VBC) arrangements do better and cost less than either their Medicare Advantage members who aren’t or people in regular Medicare FFS. To us wonks this is motherhood, apple pie, etc, particularly as proportionately Humana …

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Value-based care – no progress since 1997?

By MATTHEW HOLT Humana is out with a report saying that its Medicare Advantage members who are covered by value-based care (VBC) arrangements do better and cost less than either their Medicare Advantage members who aren’t or people in regular Medicare FFS. To us wonks this is motherhood, apple pie, etc, particularly as proportionately Humana …

Value-based care – no progress since 1997? Read More »

Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

What You Should Know: – Humana Inc. and Fresenius Medical Care North America (FMCNA) today announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage members – The agreement between Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021. Humana Inc. and leading renal care …

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Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment

What You Should Know: – Walmart announced it will begin selling Medicare insurance plans during this year’s annual enrollment period, Oct. 15 through Dec. 7. Today, Walmart announced the launch of Walmart Insurance Services, LLC, a licensed insurance brokerage, which will assist people with enrolling in insurance plans—and simplify what’s historically been a cumbersome, confusing …

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Humana lawsuit exposes fraud risk in high-growth telehealth market

Health insurer Humana has filed a lawsuit against telemedicine company QuivvyTech that it says resulted in fraudulent prescriptions worth millions of dollars being written for duped customers. According to the complaint, QuivvyTech hired telemarketers to cold-call Humana members, whose details were obtained using “illegal means,” and encouraged them to talk about common ailments, claiming to …

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Analysis: July Health IT M&A Activity; Public Company Performance

– Healthcare Growth Partners’ (HGP) summary of Health IT/digital health mergers & acquisition (M&A) activity, and public company performance during the month of July 2020. While a pandemic ravages the country, technology valuations are soaring.  The Nasdaq hit an all-time high during the month of July, sailing through the 10,000 mark to post YTD gains …

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Humana’s Bruce Broussard: Consumer Demand for Home-Based Care Models Will Continue to Increase

Humana’s (NYSE: HUM) long-standing home- and community-based focus served the insurer well in Q2 2020 — a quarter dominated by the COVID-19 emergency. The coronavirus pushed more senior care into the home, boosting business for Louisville, Kentucky-based health insurance giant. As a result, the insurer doubled down on home-based care initiatives in Q2 2020 and …

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Humana Helps Fast-Track In-Home Primary Care Company Heal’s Growth with $100M Investment

Health and well-being company Humana Inc. (NYSE: HUM) has spent the past few years adding to its health care services portfolio while aggressively investing around a home-based care strategy. The Louisville, Kentucky-based company has now revealed its latest step in that direction. On Wednesday, Humana announced a wide-ranging strategic partnership with Heal, the in-home primary …

Humana Helps Fast-Track In-Home Primary Care Company Heal’s Growth with $100M Investment Read More »

Microsoft Releases Public Preview of Azure IoT Connector for FHIR to Empower Health Teams

What You Should Know: – Microsoft released the public preview of Azure IoT Connector for FHIR (Fast Healthcare Interoperability Resources), the latest update to the Microsoft Cloud for Healthcare. – The Azure IoT Connector for FHIR makes it easy for health developers to set up a pipeline to manage protected health information (PHI) from IoT …

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Doctor On Demand Raises $75M to Expand Comprehensive Virtual Care Platform

What You Should Know – Doctor On Demand raises $75M in Series D funding led by General Atlantic to expand comprehensive virtual care. – Doctor On Demand is seeing record usage this year – up 139% – for COVID-19 screenings, routine health issues, chronic conditions and behavioral health. San Francisco, CA-based Doctor On Demand, today announced it has raised $75 million in …

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