Deciphering the New Normal (Part 3): Humana’s Chief Strategy & Corporate Development Officer, Dr. Vishal Agrawal

The previous two episodes of Healthcare is Hard explored the “new
normal” from the provider perspective with heads of strategy at
an innovative regional health system, OhioHealth, and one of the
nation’s largest, CommonSpirit. For the third episode in this
series, Keith Figlioli welcomes Humana’s Chief Strategy and
Corporate Development Officer, Dr. Vishal Agrawal, to shift the
discussion towards payers and how they’re adjusting to the
post-COVID world.

Today, Humana is one of the nation’s largest health insurers that
also provides payer-agnostic primary care, home health and
pharmacy services through its CenterWell brand. However,
delivering health care services is not new to Humana. The
company’s roots date back to the 1960s where it began as a
nursing home business, and by the 1990s, it grew to become the
nation’s largest hospital company. While its care delivery assets
eventually merged into HCA Healthcare as the company focused on
insurance, this deep history provides a unique advantage as the
industry continues its shift towards value.

In this episode of Healthcare Is Hard, Dr. Agrawal shared some of
the strategic priorities for Humana as he helps the organization
navigate the new normal in healthcare. These include:



Breaking the facility-centric model. The pandemic forced
healthcare organizations to think differently about where and
how they operate, accelerating the adoption digital and in-home
solutions. For Humana, Dr. Agrawal describes how this was a
focusing mechanism to help the company think about what it does
best, and how it could enhance and integrate those pieces to
deliver a more omni-channel approach to healthcare that people
desire. This included doubling-down on the primary care, home
health and pharmacy services Humana delivers through CenterWell
and creating an integrated delivery system with a core focus of
keeping people healthy. With this strategy, and a business
especially well-suited for the Medicare Advantage payment
model, Humana also announced in early 2023 that it would exit
the commercial insurance market to focus on government-funded
programs.


Chronic care management. In a health system that was
designed around the fee for service model and does a wonderful
job treating conditions for sick care, Dr. Agrawal believes one
of the biggest missing pieces is a similar focus on chronic
care management. He’s excited about the opportunity for
building an integrated delivery network (IDN) that brings
together high touch areas that can manage chronic health
conditions more proactively, and is optimistic about the
ability of the Medicare Advantage model to help push the
industry in that direction.


Removing waste from the system. Dr. Agrawal points out
the extreme waste in the healthcare system – which by some
estimates surpasses $1 trillion annually – and how eliminating
that waste should be a key focus for everyone. He talks about
opportunities for reducing avoidable admissions and ER visits
by keeping people healthier and innovating in areas like
nephrology, cardiology or oncology where much of the disease
and health burden exists.


Consumer choice & personalization. Healthcare is
intrinsically personal and as a result, requires many different
options for people to choose what’s right for them. Dr. Agrawal
describes how Humana is tailoring plans to meet these needs and
uses the example of the Humana Honors Plan that it built in
partnership with USAA around the capabilities of the Veterans
Health Administration. He believes we’ll see more customization
in areas like this as healthcare becomes a more consumer-driven
market.