Humana’s CenterWell Aims To Unify Senior Care Under One Roof

Senior-focused primary care is one of the fastest-growing segments in healthcare. Incumbents and new entrants alike are launching new services and jockeying for positions, especially as Medicare Advantage enrollment climbs. The push for more value-based arrangements is spurring organizations to think differently about how they serve this patient population. An important piece of the puzzle is ensuring greater coordination across the continuum.

CenterWell Senior Primary Care is at the forefront of driving the evolution of senior-focused care. During the past couple of years, CenterWell, a division of Humana, has brought primary care, home care, virtual care, and pharmacy under one umbrella to create more efficiencies and improve both the patient experience and clinical outcomes. Together with its sister brand, Conviva Care Center, CenterWell is already the nation’s largest senior-focused primary care provider with nearly 250 centers in 12 states, and CenterWell has an ambitious growth strategy, with plans to open between 30 and 35 new centers this year.

Reneé Buckingham, President of Humana’s Primary Care Organization, recently spoke with Oliver Wyman’s Parie Garg about CenterWell’s strategy and what it takes to succeed in the competitive senior care space. The following is an edited transcript.

Garg: You have united a lot of segments under the CenterWell umbrella. What was the thinking behind unifying different pieces of the industry and the development of the CenterWell brand?

Buckingham: Our focus has been around the patient — or the member — and the unique relationship they have with their primary care physician. That can be such a moment of influence when we think about engaging people in taking responsibility and accountability for their health. We've been shifting from a traditionally managed care company to a company that now has more associates engaged in caregiving than in underwriting the insurance side.

This focus led us to awareness of home as another place of influence; the home as a care destination is becoming more and more important. Our understanding of the importance of home led us to acquire the nation's largest home health company. We also have the fourth-largest pharmacy company in the country through Humana’s pharmacy benefit manager. When we started to think about the largest senior-focused primary care company, the largest home health company, and the fourth-largest pharmacy company, it became apparent that there was a tremendous opportunity to integrate those services. While CenterWell represents all our caregiving businesses, we recognized that there were also some unique opportunities to integrate the financial peace of mind that our insurance component brings.

Garg: How has that integration impacted your overall strategy and efforts to bring the full continuum of care to patients? You’ve certainly experienced significant growth over the past few years.

Buckingham: Our primary care business has more than doubled in the last four years and we will double again in less than four years. We care for approximately 266,000 seniors, and that number is growing. When you're uniquely accountable for supporting seniors in their health journey, you begin to understand the importance of home health and pharmacy. As an example, pharmacy is not just about medication adherence, but it's also about education and supporting our patients around the financial burden that may result from needing important drugs. We’re thinking about interoperability and integration across the caregiving components of CenterWell, and we're just at the beginning of the journey. Our goal is to make sure that our experience is consistent and seamless. We have a lot of work to do, but we're excited about what lies ahead.

Garg: Healthcare systems can be siloed, and we don't always step back and think about the fact that patients live most of their lives outside the four walls of the clinic or hospital. You need to take a holistic approach to care. With that in mind, let’s pivot to value-based care. In theory, the tenets of value-based care are around taking more of a whole-person approach. What kind of impact has CenterWell's strategy had on Humana's value-based care strategy as a health plan?

Buckingham: Obviously, we are an important part of how Humana thinks about value-based, senior-focused primary care. Humana recognizes the importance of the relationship between the primary care physician and the patient, and that there are not enough primary care physicians focused on the principles of value-based care.

But in any given geography, even where we may have a very large footprint, we are not necessarily big enough to meet all of Humana's needs. As such, Humana has continued to develop important strategic relationships with other value-based organizations focused on senior care. We've been a foundational partner with many of those organizations to help them either get started or help them with their growth. This is where having an asset like CenterWell has helped Humana advance its value-based care agenda outside its owned capabilities as well.

Garg: There's a lot of competition in senior-focused primary care. How does CenterWell differentiate itself?

Buckingham: Two things differentiate us from the competition:

First, we're focused on the outcomes that we drive. We think about the patient experience and the clinical outcomes.

Second, while people may know us as a brick-and-mortar primary care value-based medical group, we are very focused on the omnichannel needs of our patients. We are involved in virtual care and in-home care from a primary care perspective, not just as an extension of how we care for our clinic-based patients. As an example, the first engagement you have with CenterWell could be virtual. All of this is tied together with our home care services — CenterWell Home Health provides the last-mile services that may need to be provided when you've established a virtual relationship. And we invested in Heal and integrated it into our model, giving us an additional component of our primary care platform. We have several patients that have never set foot in our centers.

Garg: What challenges are you most worried about that could impact CenterWell's growth?

Buckingham: We have a lot of patients that count on us every single day – and so several challenges keep me up at night, but I’ll focus on the top two:

Labor: Like the rest of the industry, our biggest challenge right now is accessing appropriate labor. There are not enough nurses, there are not enough medical assistants, and there are not enough physicians to meet the ever-growing demand of our population. We are working hard on establishing relationships with key educational institutions, from residency programs to medical assistant training and certification programs.

Clinical culture: We’ve invested heavily in and focused on a dyad clinical structure. At our heart, we are a medical group driven by physicians and clinicians who are making decisions supported by good administrative partners who help them guide the business from an operational standpoint. It is very important to us that we serve as a destination employer for people who are looking for opportunities to have a good clinical culture, and work-life balance, and can feel fulfilled and connected to our mission, vision, and values around helping seniors.

To learn more contact Matthew Weinstock, Senior Editor, Health and Life Sciences.