Primary care clinics focusing mainly on older adults are more likely to serve Black patients and those dually eligible for Medicare and Medicaid, a study from Humana found.
The study, published in Health Affairs in September, studied the outcomes of older adult-focused primary care organizations and found the organizations tend to enter and serve historically more disadvantaged communities. The authors defined such organizations as reimbursed predominantly through population-based payment arrangements and serving mostly older adults with Medicare.
Humana's CenterWell is one such organization, alongside Oak Street Health and One Medical Seniors.
CenterWell is expanding, with plans to enter three new markets in 2024. The company aims to add 30 to 50 new centers per year through 2025 and will also open clinics at 23 former Walmart Health sites.
The study, conducted in partnership with Harvard University researchers, is the first of its kind to investigate CenterWell and similar providers, according to a news release.
Vivek Garg, MD, chief medical officer and senior vice president of primary care at Humana, told Becker's that the study results "mirror the focus our teams have around getting to know their patients."
The study also found that Medicare beneficiaries receiving care through older adult-focused models had 17% more primary care visits than their peers, with the effects being more pronounced among Black beneficiaries and those dually eligible for Medicare and Medicaid.
Dr. Garg spoke with Becker's to discuss the study's findings, the future of primary care models, and Humana's move into Walmart stores.
Editor's note: Responses have been lightly edited for clarity and length.
Question: Did anything in the study results surprise you?
Dr. Vivek Garg: I was particularly intrigued, pleased and think there's a lot of importance around the subgroup analyses that focus on Black seniors, and dual-eligible and low-income, subsidy-eligible seniors. These are even more vulnerable, undermet need populations across the country. To see the results around quality, utilization indicators and the amount of primary care engagement that groups like [Centerwell] can bring to those subpopulations, and how it closes the gap, in some of the indicators of quality of health and outcomes — we've been searching for things for decades that can help us meet the disparities in healthcare that exist. This model feels like a part of that solution set. It's obviously not the only thing to do or that we should care about, but I think that was really validating for our team members who see it every day. They come from these communities, want to serve these seniors and these groups. It takes a lot of time, attention, effort and love.
Q: Given the success of the CenterWell model, how large do you think the space can grow? Will the model eventually become the dominant way older adults receive primary care?
VG: Humana has obviously taken a very multidimensional approach to supporting good primary care for seniors in so many ways, including value-based partnerships, ACO models, partnering with other groups like ours, partnering with other independent primary care groups, and helping to support the development and growth of CenterWell primary care. I do think we have a societal need to figure out how to really expand comprehensive access to good, team-based primary care. Within that, my personal hope is that we do see senior primary care continue to grow. It can come in all sorts of flavors, and it can serve everyone on Medicare. One of the things our group and some other groups like ours do is we also work with people on original Medicare benefits, and they enroll in our ACO program. I think the government is enabling different flavors and versions of this population-based payment, which started with Medicare Advantage plans supporting groups like ours. It lets you build the time, the resourcing, the frequent touch points, and really helps you orient around these underserved communities and sets of seniors.
Q: Humana is moving into more than 20 former Walmart Health sites. As chief medical officer, what do you see as the benefits of being co-located with these stores?
VG: We're really excited about that next step. Walmart built beautiful primary care clinics, and we have the opportunity to bring the model of care into that physical space. It's just a great primary care environment. Our teams are really excited as they've toured them. We signed 20+ leases, and we're going to stand up our primary care teams and model in those sites. It's a great situation to provide good, respectful primary care to seniors.
Everybody knows Walmart. Everybody knows how to get to a Walmart. They're situated in communities with the needs we're talking about, in many cases. We do see that seniors need easy, visible, convenient ways to get to a place. We often, outside of this arrangement, are in retail shopping environments, in communities, ideally within a few miles of where the people are. Getting around can be tough for seniors, so obviously, we need to be where they are.
Then there's all the other things that a partner like Walmart does through the other services it provides, some of which are health related, some of which are groceries and other supplies. It's just more one-stop shopping for seniors. In this journey of making things that are important to their daily health and lives as easy as possible for them to access, I think this will be a great step.