Humana (NYSE: HUM) is tackling substance use disorder (SUD) among pregnant women with its latest investment. It’s just another example of the insurance giant’s commitment to creativity in the behavioral health space, according to Chief Medical Officer William Shrank.
“None of us can solve these really, really big problems alone,” Shrank told Behavioral Health Business. “It requires partnerships with those providing care on the ground. It requires partnerships across financing. It requires creativity as we think about how to solve problems across an entire population, rather than the fragmented approach that any single payer or any single provider could deliver.”
Such partnerships are key to Humana’s new SUD investment. The insurer announced last week that it invested $5 million in an outcomes-based fund supported by Quantified Ventures, a B Corporation that drives transformative health, social and environmental impact through outcomes-based capital.
The fund will help the national nonprofit Volunteers of America scale its family focused recovery (FFR) program, which provides addiction treatment and wrap around services to pregnant mothers with SUD and their children.
The FFR programs are equipped to include housing support, medication-assisted treatment (MAT), targeted case management, outpatient offerings and long-term follow up services. The goal is not only to support mothers, but also the family unit as a whole.
“There’s a number of effective programs out there, and the current funding streams for those are not predictable enough to drive them to scale,” Shrank said. “The goal here was to partner with innovative organizations to try to create something that’s more scalable and really a chassis not just for us at Humana, but for other payers and for entire communities to work together to support mothers with SUD.”
The service is meant to be available to any mother who chooses to participate, Shrank said, calling the initiative consumer-focused rather than Humana-focused. In fact, the company hopes to see participation from additional payers in the future to help increase program visibility and enrollment.
While $5 million is but a drop in the ocean for a huge corporation like Humana, which boasts billions of dollars in revenue, Shrank said the initiative speaks to the company’s commitment to behavioral health. Though the aforementioned partnership has been in the works for more an a year, COVID-19 has intensified Humana’s overall behavioral commitment in other ways.
“[The coronavirus has] just highlighted the notion that we, as both a payer and a provider, have an absolute obligation to think about the holistic set of needs and challenges that our members are facing during these uncertain times,” Shrank said. “And how critical it is to integrate behavioral and social concerns or issues, along with the physical health of our members.”
During the COVID-19 emergency, Humana has done that in part by waiving copays for telehealth services in both the physical and behavioral health realms. While Shrank wasn’t able to provide specifics on what Humana’s tele-behavioral policies would look like in 2021 and beyond, he said the company would continue to make it a priority going forward.
“At a high level, we are deeply committed to endorsing and paying for all telehealth services,” Shrank said. “In Medicare Advantage and commercial, it is easier for me to say definitely, ‘Yes, we will be providing telehealth coverage.’ In state Medicaid programs, we obviously have to work independently with each state.”
Meanwhile, another area Humana is especially bullish on amid the coronavirus is value-based payments. In fact, the company has designed and implemented a number of value-based contracts that explicitly reward providers for collecting information on and addressing social determinants of health. It’s an innovative area the insurer hopes to expand upon in the future, Shrank said.
“[Amid COVID-19, providers] that had the most progressive value-based arrangements were most resilient and most prepared to care for members holistically,” Shrank said. “And as a result, … we’ve seen more interest in engagement and value-based arrangements.”
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