Humana expands screening at home as patients shun medical visits

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(Bloomberg) -- Health insurer Humana Inc. is sending at-home screening tests for cancer and other conditions to more than a million of its members who may have postponed medical care because of Covid-19.

The kits will allow members to collect samples of blood, urine or stool without having to go to a clinic. The program is focused on managing diabetes and screening for colorectal cancer. The materials will be sent to members who Humana’s data indicates are due for screenings.

“The goal is to reduce all barriers possible for access to essential preventive care,” said William Shrank, Humana’s chief medical officer.

The tests are part of Humana’s broader strategy to deliver more health care at home. Humana has previously announced plans for home-based Covid testing. It has also said it will waive cost-sharing for Medicare patients for primary care, behavioral health and telehealth visits through the end of 2020.

“We’re working really hard to figure out how to improve the safety of our members at home, and make sure that they access as much care as possible,” Shrank said.

During the pandemic many people have deferred or skipped in-person medical visits because of fear of exposure to Covid-19. That has diminished revenue for doctors and hospitals while leaving insurers flush with cash. The inadvertent windfall has led to insurers rebating money to customers and waiving patients’ costs.

Humana is focused on Medicare Advantage health plans, a segment that faces a particular risk from the pandemic distorting normal patterns of medical care. The payments Medicare plans receive from the government are linked to a measure that is supposed to reflect how sick the plan’s members are. The government pays higher rates to insurers for covering people who need more medical care.

If patients aren’t getting the care they usually would this year, that could lower the so-called risk scores and reduce payments to Medicare plans next year, potentially below their costs, consultant Avalere said last month.

Shrank said the at-home screenings aren’t used in a way that would influence risk scores. “The rationale for these tests is that we want to make sure that our members are getting needed preventive care,” he said.

The tests will allow people with diabetes to check whether their blood sugar is well-managed over time and assess their kidney function. The colon-cancer screening looks for early signs of blood in the stool that could indicate a patient needs a colonoscopy. Results will be sent to members’ primary-care doctors, and Humana will reach out if people don’t get the appropriate follow-up care.

With strong evidence in favor of such routine screenings, Shrank said, “any delay is a problem.”

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