Humana’s plan to lower the number of elderly patients who seek care in the emergency room could end up costing urgent care centers. The company is testing a telehealth program that encourages Medicare Advantage enrollees to try “virtual” visits for relatively minor complaints before they head to the hospital. On-call clinicians would have access to the patient’s medical history and the authority to direct the patient’s care (which could still entail a trip to the ED).

The risk to urgent care is that it could get shut out as payers and providers engage in triage via telemedicine, steering captive patients to telemedicine and other lower cost solutions.

Humana also plans to discontinue several products offered under the Affordable Care Act. The company says it will target plans whose “product designs…attracted a higher-utilizing member base than was assumed when the 2015 plan offerings were priced.”

Humana Moves Could Impact Older Patients and Urgent Care
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