Humana, Walgreens to Open More Clinics for MA Beneficiaries; AHIP Releases MA Report

Health insurer Humana and drug store chain Walgreens announced Tuesday they are opening joint primary care clinics for senior citizens in Kansas City, Missouri. Partners in Primary Care, a subsidiary of Humana, serves Medicare Advantage (MA) beneficiaries.

Also Tuesday, a report from America’s Health Insurance Plans (AHIP) found that MA populations continue to be more diverse and represent a larger share of low-income seniors than traditional fee-for-service (FFS) Medicare beneficiaries.

The Humana—Walgreens deal joins primary care, pharmacy, in-person health plan support and other services in 2 clinics scheduled to open this fall. The companies previously opened another 4 clinics last year. Humana serves more than 65,000 Medicare Advantage and Medicare standalone Part D prescription drug plan members in the area. Walgreens serves more than 75,000 Medicare beneficiaries in the Kansas City area.

The arrangement comes as health insurers and pharmacy chains are searching for more ways to integrate. Earlier this year, CVS Health announced plans to buy Aetna, and there have been reports that Walmart and Humana were interested in combining operations.

Separately, AHIP released a report looking at demographic data from 2015. The data comes from the Medicare Current Beneficiary Survey (MCBS), which is produced by CMS. About 32% of all Medicare beneficiaries were enrolled in MA in 2015.

Unlike Medicare FFS, MA beneficiaries receive additional benefits, such as coverage for prescription drugs, vision, hearing, dental, and wellness care. In addition, CMS is allowing payments for services tied to social determinants of health, such as meal delivery and transportation to appointments.

MA had a higher overall share of diverse populations—30%— than the 23% in Medicare FFS, the AHIP report said. MCBS survey estimates show that 48% of Hispanic Medicare beneficiaries and 38% of African-American Medicare beneficiaries were MA plan members. While the proportion of African Americans and Asians enrolled in MA plans and Medicare FFS were largely similar, MA plans had a higher proportion of Hispanic beneficiaries: 13% compared with 7% for Medicare FFS.

Females made up 57% of Medicare beneficiaries with MA coverage in 2015, compared with 54% in Medicare. MA plans had a higher percentage of beneficiaries age 75 years and older: 38% compared with 34% for Medicare fee-for service (FFS).

Fifty-three percent of MA beneficiaries had annual incomes of less than $30,000, compared with the 46% of Medicare FFS; 28% had annual incomes of $50,000 or more, compared with 37% of Medicare FFS. About 28% of Medicare Advantage enrollees had incomes of $50,000 or more, compared with 37% of Medicare FFS beneficiaries.

While the proportions of dually eligible beneficiaries over 85 were similar across MA and Medicare FFS, differences were observed in other age categories. MA beneficiaries made up the largest category in the 75 to 84 (23%) and 65 to 74 age groups (32%) versus 16% and 27% for Medicare FFS, respectively.

Medicare FFS had a higher proportion of beneficiaries younger than 65 years (49% versus 36% for MA).