LOUISVILLE, Ky. (WDRB) — At Humana's new CenterWell Clinic in south Louisville, seniors might show up for a doctor's appointment — or to play bingo, attend a birthday party or enjoy a movie night.
The "senior-focused" primary care clinic, occupying a storefront in the South 2nd Street shopping center anchored by Kroger, is in many ways a typical doctor's office. It has a dozen exam rooms, a waiting area and a room for lab draws.
But the clinic also includes an "activity room" where older people can socialize, regardless of whether they're patients of the clinic.
"Health is more than just the physical, right? It is the emotional, the mental aspects as well," said Nick Judd, CenterWell's market president for Kentucky and Indiana. "Social isolation — which is a really big issue within our senior population — rooms like this help to bring seniors in and (to) be with others from the community."
Humana's first CenterWell clinic in Louisville, which opened last month, is part of the health insurer's multibillion-dollar push into treating patients instead of simply paying their claims.
The Louisville-based company makes most of its money from Medicare Advantage, the private version of the federal government's health coverage for seniors. As the second-biggest player in Medicare Advantage, Humana covers about 4 million members, taking a razor-thin cut of premiums paid by the government for each member.
While insurance will remain the bulk of Humana's revenue for years to come, the company has recently evolved back to its roots as a health care provider. Humana started in 1961 as nursing home operator before becoming a hospital company until the 1990s, when insurance became its main business.
CenterWell, a brand Humana launched last year, encompasses the company's growing number of "senior-focused" primary care clinics; the home health care business it acquired from Louisville-based Kindred health care; and its mail-order pharmacy.
Humana has more than 220 primary care clinics operating under the CenterWell and Conviva brands in 11 states. The south Louisville clinic is the first of three planned for Louisville and two for southern Indiana — part of 30-35 clinics Humana plans to add annually for the next few years.
The clinics treat only Medicare patients, though they are not limited to patients covered by Humana's Medicare Advantage plans. CenterWell clinics will also treat patients with Medicare Advantage plans offered by Humana's competitors and with "original" Medicare directly from the federal government, Judd said.
The CenterWell clinics promise a concierge experience with wait times of 5 minutes or less and visits that last at least 40 minutes. CenterWell employees will even help patients find transportation to their appointments, with the clinic paying the bill if it isn't covered by their health plan, Judd said.
The clinics operate "value-based" care, in which providers' pay is tied to keeping patients healthy and avoiding unnecessary hospital stays rather than the volume of patients they see or the procedures they perform.
CenterWell physicians and nurse practitioners are meant to see only about half as many patients per day as a typical doctor's office, said Chad Hester, associate director of field sales and growth for CenterWell Senior Primary Care.
For now, Humana is concentrating on "underserved" areas of Louisville where seniors have fewer health care options, Judd said. The company just opened a second CenterWell clinic in Okolona, and its third is planned for west Louisville in 2023.
"This is not an urgent care model. We're not looking to just react sick visits," Judd said. "We're looking to engage our patients early and often … We're very intentional about trying to bring this model to the populations that need it the most."
The business rationale for CenterWell — whether a clinic or a home visit — is for Humana to share in the savings from keeping its Medicare Advantage members healthy and to retain more of them from year to year.
Seniors can switch Medicare plans every fall, and Humana's lower-than-expected growth in members last year prompted a reorganization of the company and a plan to find $1 billion in administrative savings — which has included layoffs — to fund more attractive Medicare benefits.
The CenterWell clinics could triple the thin profits Humana earns from its Medicare members, according to an August analysis by BofA Securities.
The bank's analysts estimate that Humana could retain $156 from its typical Medicare member's $1,000 monthly premium via a CenterWell clinic, up from earnings of $45 from the insurance plan alone.
However, the clinics can't survive on Humana-insured patients alone, and they are supposed to generate profits independently.
The typical clinic will break even in about three years and achieve about $3 million in profits within 6-7 years, Humana told Wall Street analysts in a September presentation.
The south Louisville clinic, which opened Oct. 24, appears to have a long way to go. A single patient came through the door during WDRB's hour-and-a-half visit Monday morning.
Judd said it's normal for clinics to start with a small patient base. Seniors aren't familiar with the CenterWell brand, so the company will hold a "grand opening" with games and attractions at the south Louisville clinic on Dec. 1.
"Obviously, when you open up a new practice, a new center, we have to engage the community and educate them on what we're doing here," he said.
Louisville-area patients interested in CenterWell can call 502-918-0088 or visit this site.
