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Humana and FMCNA Expand Collaboration to Improve Care Coordination
Expansion of Services to Benefit Humana Medicare Advantage and Commercial Members
LOUISVILLE, Ky. & WALTHAM, Mass. — Oct. 6, 2020 — Leading health and well-being company Humana Inc. (NYSE: HUM) and leading renal care company Fresenius Medical Care North America (FMCNA) today announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage and commercial members with chronic kidney disease (CKD) and end stage renal disease (ESRD) through more coordinated, holistic care.
The expanded partnership is in keeping with the goals outlined in the 21st Century Cures Act, which enables people with ESRD to enroll in Medicare Advantage Plans, and with federal initiatives that call for earlier diagnosis and treatment of kidney disease; a reduction in the number of Americans developing ESRD; and support for patient treatment options such as home dialysis or kidney transplant as applicable.
The agreement between Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021, and encompasses the following:
- Expanded Availability of Care Coordination Services: FMCNA currently provides specialized care coordination services for Humana members with CKD in three states: Iowa, Kentucky, and North Carolina. The agreement expands the availability of these services to eligible Humana members in an additional 39 states, with the goals of improving quality of life and health outcomes, increasing access to care and minimizing care gaps, slowing disease progression and lowering hospitalization rates, and reducing the cost of care.
FMCNA's care coordination services include early detection of CKD to slow disease progression; medication reviews and regimen adherence guidance; behavioral health screenings; nutritional counseling; strategies for managing multiple comorbidities; education about - and support for - home dialysis treatment when applicable and beneficial to the patient; transplant education; and palliative care.
FMCNA partners with InterWell Health, a physician-led population health management company working to improve clinical outcomes and lower medical costs through its network of over 1,100 nephrologists across the country.
- Transitional Care Units: These units are designed to help people recently diagnosed with kidney failure learn about treatment options available to them - including transplant and home dialysis - and be more empowered in managing their own care. Transitional Care Units may be either a space within a dialysis center or a standalone facility, offering comprehensive, hands-on education from dedicated staff that is individualized for each patient. This includes the importance of renal nutrition, medication adherence, and vascular access care; assisting patients transitioning between modalities (e.g., from in-center dialysis to home dialysis); and supporting individuals returning to dialysis from transplant. The agreement is intended to locate Transitional Care Units in select areas where Humana has significant Medicare Advantage membership.
- Value-Based Agreement: The expanded collaboration also improves upon the parties’ existing clinic network contract, which provides eligible Humana Medicare Advantage and commercial members with ESRD access to dialysis at more than 2,600 centers of Fresenius Kidney Care, the dialysis services division of Fresenius Medical Care North America. By implementing a value-based payment model for in-center and home dialysis services and at Transitional Care Units, as well as for CKD care coordination services, compensation will be based on meeting agreed-upon quality improvement and patient outcome goals, and reducing overall costs to the system.
Value-based renal care is aligned with the objectives of CMS’s recently-released End Stage Renal Disease Treatment Choices (ETC) Model, which encourages increased adoption of home dialysis and greater access to kidney transplants.
“As Humana continues to prioritize innovative solutions in response to today’s greatest health care challenges, we’re pleased to collaborate with Fresenius Medical Care North America, an organization of broad capability with which we can execute an important initiative of this scale,” said William Shrank, M.D., M.S.H.S., Humana's Chief Medical Officer. “In the evolution of renal disease care, we are confident that the best way to improve health outcomes and the patient experience is personalized coordination that meets the needs of each individual. That’s especially vital in the midst of the coronavirus pandemic.”
“This agreement represents an evolution of our work with Humana and leverages our over 10 years of industry leadership in value-based care,” said Bill Valle, Fresenius Medical Care North America’s Chief Executive Officer. “Our scale, integrated nephrology network, and standardized clinical interventions and protocols uniquely position us to predictably and consistently improve health outcomes and reduce overall costs. We welcome this opportunity to offer more coordinated, holistic care to Humana’s members, with a keen focus on education, comorbidity management, early detection, and treatment options, including home dialysis. This approach also helps eliminate barriers to keep renal disease treatment uninterrupted for at-risk populations.”
Individuals with CKD have kidneys that do not filter blood properly, which causes waste and fluid levels that can be dangerously high. CKD and ESRD affect a wide spectrum of the population but the degree of impact is not uniform. For example, kidney failure rates among Black Americans are about three times that of white Americans. In total, approximately 15% of American adults, or about 37 million people, have CKD, but many are unaware of their condition. CKD management is complex, and failure to appropriately manage the condition may cause considerable symptoms and worsening health outcomes, including ESRD.
Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.
To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission filings
- Most recent investor conference presentations
- Quarterly earnings news releases and conference calls
- Calendar of events
- Corporate Governance information
Other providers are available in our network. The provider may also contract with other Plans.
About Fresenius Medical Care North America
Fresenius Medical Care North America (FMCNA) is the premier healthcare company focused on providing the highest quality care to people with renal and other chronic conditions. Through its industry-leading network of dialysis facilities and outpatient cardiac and vascular labs, Fresenius Medical Care North America provides coordinated healthcare services at pivotal care points for hundreds of thousands of chronically ill customers throughout the continent. As the world's largest fully integrated renal company, it offers specialty pharmacy and laboratory services, and manufactures and distributes the most comprehensive line of dialysis equipment, disposable products, and renal pharmaceuticals. For more information, visit the FMCNA website at https://fmcna.com/.