Humana’s hire portends big things for its primary care business


Humana named Dr. Vivek Garg chief medical officer of its primary care organization on Thursday. He is charged with directing the future of the company’s growing but disjointed primary care businesses.

Garg, who previously served as CMO of New York-based CareMore Health integrated delivery system, will offer clinical leadership for the Louisville-based insurer’s primary care arms, which include the CenterWell Senior Primary Care brand and Conviva Care Centers. He will report to Renee Buckingham, segment president of primary care at Humana.

“Dr. Garg’s advanced expertise in patient care, clinical collaboration and innovative care delivery will be instrumental in our continued success,” Buckingham said in a news release. “His commitment to both our model—a whole-person approach including physical health, mental wellbeing, and social needs—and to our ongoing evolution is an asset to the organization.”

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Humana did not immediately respond to an interview request and questions about whether Garg was the first CMO of its growing primary care segment. But his appointment comes as the company expands its retail footprint and services for seniors, echoing moves by other insurers aimed at lowering their cost of care by providing better management of individuals’ chronic conditions. The company has been the driving force—and the pocketbook—behind a new kind of senior primary care clinics that have exploded across the U.S.

In February 2020, Humana announced a $600 million joint venture with private equity firm Welsh, Carson, Anderson and Stowe to develop senior-focused primary care centers, which operate under its CenterWell brand. WCAS is the majority stakeholder in this venture.

This March, the insurer’s Conviva subsidiary paid an undisclosed sum to buy 12 senior clinics in Florida, bringing on more than 200 workers, including 40 doctors, physicians assistants and advanced practice nurses. The deal also added 49 affiliate practices to Conviva’s network through downstream participation arrangements.

In July, newly-filed public documents revealed that Humana funded development of 40 of Iora Health’s 47 clinics, with Iora promising to only serve the insurer’s senior members at these primary care centers until July 2020. In June, One Medical announced it would pay $2.1 billion to acquire Iora, in a move to enter the lucrative Medicare Advantage market and trasition from fee-for-service payment.

Humana has also helped fund clinics for primary care startup Cano Health and Oak Street Health, which is now the AARP’s clinic of choice for its members. The company also has a joint venture with Miami-based ChenMed, another primary care startup.

By early 2022, Humana expects to have opened another 20 new CenterWell Senior Primary Care centers in Georgia, Louisiana and Nevada. By the end of 2021, the company expects to operate 200 CenterWell and Conviva offices nationwide. Providers at these facilities currently see approximately 60,000 Medicare Advantage and traditional Medicare patients, many of whom live in medically underserved areas and are not enrolled in a Humana plan.

“I was drawn to this position not only for its innovative approach to care delivery, but also for the opportunity to work side-by-side with the organization’s care teams, whose commitment to caring for seniors holistically and proactively, especially during this difficult pandemic, is inspiring,” Garg said in a news release.

Humana is the second-largest Medicare Advantage insurer in the nation, with 4.3 million members reported during the company’s most recent second quarter ended June 30. The insurer expects to add 475,000 new Medicare Advantage enrollees this year.

Medicare Advantage is by far the most profitable line of business for private insurers.


Source: modernhealthcare.com

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