Humana, private equity firm launch 2nd primary care joint venture for Medicare patients

USA – Humana’s CenterWell and Welsh, Carson, Anderson, and Stowe have formed a new joint venture focused on value-based primary care.

The two partners will invest US$1.2 billion in the venture to build 100 new senior-focused primary care clinics between 2023 and 2025, and then operate these locations to ensure profitability.

The move comes as traditional payers compete with rival startup insurtechs for lucrative Medicare Advantage members, for whom the government pays a flat fee rather than fee-for-service, with payers taking on the risk of caring for those seniors.

Humana lowered its outlook for merger and acquisition plan member growth earlier this year as members actively shopped and generated churn in the industry during the most recent open enrollment period, and the payer lost members to other insurance carriers, according to CEO Bruce Broussard.

It is now looking to expand its primary care clinics into new markets, and by the end of 2022, it expects to serve Medicare patients in approximately 250 clinics, according to the release.

CenterWell Senior Primary Care is the country’s largest provider of senior-focused primary care, and it is actively working to expand through a variety of strategies.

Humana’s primary care business operated 217 clinics under the CenterWell and Conviva Care Solutions brands as of March 31, including 37 under the initial joint venture with WCAS.

According to Humana, the 214 locations serve approximately 180,000 Medicare Advantage enrollees through value-based care arrangements.

Humana and WCAS first collaborated in February 2020, committing US$800 million to the opening of 67 clinics by early 2023.

According to the announcement, WCAS will have a majority stake in the joint venture and Humana will have a minority stake.

CenterWell Senior Primary Care is the country’s largest provider of senior-focused primary care, and it is actively working to expand through a variety of strategies.

Humana’s CenterWell Senior Primary Care and Conviva Care Solutions brands will operate the clinics.

Centerwell, Humana’s health services division, was recently rebranded, and its senior-focused primary care clinics were previously known as Partners in Primary Care in several states and Family Physicians Group in the Orlando area.

The payer will be paid a management fee, as well as performance-based incentives, for managing all joint venture clinics.

The agreement also includes put and call options for Humana to purchase WCAS’s interest. Humana can do so starting in 2028, or five years after each cohort of clinics opens.

WCAS may require Humana to purchase its interest starting in 2030, or seven years after each cohort of clinics opens.

MA membership has increased year after year since the early 2000s, and MA enrollees made up 42 percent of the total Medicare population in 2021.

According to the Kaiser Family Foundation, that figure is expected to rise to 51% by 2030.

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