Humana is now working with kidney care company Interwell Health for some of its Medicare Advantage members, the companies announced Wednesday.
Humana has about 17.1 million members, and 5.1 million are Medicare Advantage members. Cambridge, Massachusetts-based Interwell Health works with public and private payers and serves patients with chronic kidney disease and end-stage kidney disease.
In the new agreement, Interwell Health will provide care to Humana Medicare Advantage HMO and PPO members with chronic kidney disease in 13 states. It will also serve patients with end-stage kidney disease across the country. The 13 states where the chronic kidney disease support will be offered are Arizona, Arkansas, Colorado, Kansas, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas and West Virginia.
Interwell Health offers patients access to a network of 1,700 nephrologists. It also connects patients to a care team, including nurses, dietitians and social workers. It provides care coordination services like appointment scheduling and resources like diet support and prescription management. The company’s team serves patients in their homes, virtually and at the physician office.
“We work with payers … to identify the kidney population a little earlier and go upstream to engage when they’re in stage four or stage five, when the kidney is kind of center-stage in their care but we can do something about it,” said Bobby Sepucha, CEO of Interwell Health, in an interview. “We can help patients manage their meds, we can help patients think about diet and ultimately slow progression.”
The relationship between Humana and Interwell Health is a value-based care agreement, in which payment is tied to patient outcomes rather than the quantity of services provided, said Carl Daley, Humana senior vice president. Daley did not say which outcomes the agreement is tied to, but Sepucha said Interwell’s arrangements with payers are typically based on factors like reducing hospitalizations and costs.
Currently, kidney diseases are the leading cause of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). About 37 million adults in the U.S. have chronic kidney disease, yet 40% of those with reduced kidney function don’t know they have chronic kidney disease. Another 808,000 Americans are living with end-stage kidney disease, according to the National Institute of Diabetes and Digestive Kidney Diseases. Chronic kidney disease cost Medicare $87.2 billion in 2019, and end-stage kidney disease cost $37.3 billion, the CDC reported.
“[Kidney disease] is largely asymptomatic until it progresses close to kidney failure,” Sepucha said. “The standard of care for too many people in this country is to do what’s called crashing into dialysis, or they show up at the emergency room with chest pain or blurred vision. And the doctor will run a quick blood test and tell the patient, probably for the first time, ‘You have kidney disease. In fact, your kidneys have failed.’ And they plunk a catheter in their neck and put them on dialysis.”
Humana chose to work with Interwell Health because of this large number of people affected by chronic kidney disease.
“With millions of Americans currently living with chronic kidney disease and that number continuing to grow – it’s essential that we increase access to evidence-based, multi-specialty kidney care to ensure our members have the services they need,” Daley said. “To do this, we are building on our existing relationships with kidney care providers and exploring additional opportunities to provide the highest levels of support and access to kidney care for our members.”
The Humana-Interwell Health partnership comes after Humana announced another partnership with Monogram Health, also a value-based kidney care company, in October. That relationship serves Humana Medicare Advantage HMO and PPO members with chronic kidney disease in Tennessee, Alabama, Mississippi and Louisiana. Another value-based kidney care company is Strive Health, which offers at-home and virtual support for chronic kidney disease, end-stage kidney disease, dialysis and kidney transplants.
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