Louisville, Ky.-based Humana Inc. and kidney care management company Interwell Health, have expanded their value-based care agreement to include Florida for Humana Medicare Advantage members living with chronic kidney disease (CKD) and end-stage kidney disease (ESKD).
Interwell’s value-based support services are now available in 14 states for eligible members with CKD, and in 39 states for eligible members living with ESKD.
Interwell’s comprehensive care and specialized resources include 2,000 network nephrologists, renal care coordinators, and in-home virtual support from dietitians, nurses, social workers, pharmacists, and care coordinators.
“Tens of millions of American adults currently live with chronic kidney disease,” said Caraline Coats, Florida Medicare President at Humana, in a statement. “As the numbers continue to grow, so is the need to provide our members living with chronic and end-stage kidney disease with access to value-based, coordinated care. We are grateful to be able to bring this program to Florida.”
Humana recently released an issue brief documenting its success in value-based partnerships for kidney care, including a 5% reduction in unnecessary hospital admissions in 2023.
Interwell Health was formed in 2022 by the merger of Fresenius Health Partners, the value-based care division of Fresenius Medical Care North America, with Cricket Health and Interwell Health, a network of nephrologists.
In January 2024, George Hart, M.D., Interwell’s chief medical officer, spoke with Healthcare Innovation. “The private payer sector is very interested in continuing to cultivate a relationship with us as it relates to both commercial populations and Medicare Advantage populations,” he said. “We’ve expanded some of our pre-existing agreements and are continuing to talk with both national and regional players. We've expanded our footprint down into Puerto Rico. We're working with two large payers down there. Who we partner with is changing. We know that we need to figure out not just how to work with nephrologists, but also work with primary care, work with surgeons. So I think we're putting a toe in the water, so to speak, in those arenas, which we think is going to bear fruit and teach us how to better be prepared to go further upstream in the earlier stages of CKD.”
Speaking about the advantages of value-based care models, Hart said that Interwell has “an ability to invest in things like education, care navigation, and starting those conversations earlier in the disease process, where you have the time to deal with adherence issues. We now have the ability to follow up with these patients, and help them get from point A to point B and make sure that they don't miss appointments, make sure they have a ride. So the chance of failure is minimized versus what it would be in a fee-for-service model.”
