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NEW VETERANS UNIT COULD BE BIG BUSINESS FOR
HUMANA, INC. -- Humana's next step in
privatizing the VA is
led by former VA deputy assistant secretary
Alfonzo Poteet.
This story starts over a year ago with a press
release from Rep. Steve Buyer (R-IN), then Chairman of the House
Committee on Veterans' Affairs. Press release here...
http://www.vawatchdog.org/housecv
anews/housecvanews03-29-06-2.htm
In the release, Buyer speaks of Project HERO, a
move to outsource (privatize) healthcare for rural veterans.
A few days later, I wrote this: "This is
a lesson in political manipulation. Give your program a compelling
name: Project HERO. Tell people that it will not do what it is
really designed to do: Privatize VA healthcare. Then, sit back and
watch people buy into it." That story here...
http://www.vawatchdog.org/old%20newsflashes
%20APR%2006/newsflash04-02-2006-1.htm
Also in the above story is this from former
Rep. Tom Osborne (R-NE): "Under the Project Hero program, Osborne
said Thursday, veterans could go to their local hospital and be
reimbursed for the care."
You can give it a nice name and you can tell us
how wonderful it will be, but it is still privatizing the VA.
Buyer stated: "This initiative is not
intended to undermine our affiliations, or lead to expanded outsourcing
or the replacement of existing VA facilities."
However, the VA is closing facilities and they
are moving to more outsourced healthcare. VA employees are not
being hired to run new Community-Based Outpatient Clinics (CBOCs).
The VA just announced they are building 38 new CBOCs and most of those
will be run under contract by private providers. Story here...
http://vawatchdog.org/07/nf0
7/nfMAY07/nf053007-8.htm
And, we have this warning from the DAV:
"...private providers 'would inevitably grow over time and place at
risk' the comprehensive services the VA provides."
Please carefully read the article below.
You will see that Humana is greedy and wants a big chunk of VA
healthcare money.
Today's story here...
http://www.mlive.com/
business/ambizdaily/bizjour
nals/index.ssf?/base/abd-3/1
18093922659670.xml
Story below:
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New Veterans unit could be big business for
Humana Inc.
Ed Green - Business First
Humana Inc. has started a small subsidiary to focus on increasing its
work on government-sponsored programs -- a business that could produce a
hefty new revenue stream for the Louisville company.
Some of the details about the unit, Humana Veterans Healthcare Services
Inc., are in flux because its business depends on getting requests for
proposals to provide services to the U.S. Department of Veterans
Affairs.
If Humana Veterans wins contracts, it will collaborate with the VA to
help manage the quality and cost of health care services for a growing
number of former military personnel who are eligible for VA benefits,
said Alfonzo Poteet, CEO of Humana Veterans.
Poteet, a former deputy assistant secretary for the Department of
Veterans Affairs, and two other executives were hired to develop the
business, which is not yet generating revenue.
Work could start soon
The three officials already have worked on bids for Humana to provide
services for the VA, and the unit will boost employment in Louisville
later this year to fulfill any contracts it wins, Poteet said.
He declined to estimate how many workers will be needed or how much
revenue the unit will generate.
But he acknowledged that based on the billions of dollars the VA spends
each year on health care, creating a business that supports the VA's
mission could spark significant revenue for Humana.
Last year, $14.6 billion of the company's $20.7 billion in premium
revenue came from government sources.
Last month the unit submitted a proposal for a repricing contract that
would allow Humana to negotiate lower charges within an existing network
of health care providers that treat eligible veterans outside the VA
health care system.
Humana would receive part of the overall savings if it wins the
contract, Poteet said.
Project HERO designed to save money
Another contract on which the company recently bid is a pilot program
called Project HERO, or Health Care Effectiveness through Resource
Optimization.
Project HERO was launched earlier this year "to reduce VA contract costs
while improving access, accountability, care coordination, patient
satisfaction and clinical quality" of care provided by institutions
outside the VA system, according to information from the VA's Web site.
The first phase of the project is to establish a network of specialty
providers to offer care that is not available within the VA system.
The VA has selected four of its Veterans Integrated Services Networks,
or VISNs, to test the project. The networks are made up of multiple
states and geographic areas where the VA provides benefits to eligible
veterans.
Humana has bid to manage the health care network for all four VISNs,
which comprise about 25 percent of the 7.7 million veterans enrolled in
the VA's programs.
Veterans' organizations object to plans
Officials with the VA declined several requests for interviews about the
HERO program and the VA's work with private companies such as Humana.
Laurie Tranter, a spokeswoman for the VA in Washington, D.C., said
officials will not comment on the program until it responds to bids
later this year. She said she does not know how many companies have
submitted bids for the project.
Officials with several veterans' organizations, including the Cold
Spring, Ky.-based Disabled American Veterans, criticized the HERO
program during testimony before a congressional committee earlier this
year.
David W. Gorman, executive director of the DAV, testified that officials
worry that "in an open environment of mixed government and private
providers with tight budgets," private providers "would inevitably grow
over time and place at risk" the comprehensive services the VA provides.
Work for VA could be broad
Poteet said Humana officials are not seeking to replace services the VA
already provides but will complement its services by bringing in the
company's experience in managing health benefits.
He also described Project HERO as a "subset" of what Humana hopes to do
for the VA.
Other services the company would like to provide are disease and
utilization management, patient appointment services, provider network
development, resource staffing and referral management.
Humana's Military Healthcare Services unit already provides many of
those services to the government.
The 11-year-old division manages benefits for about 2.9 million people
covered under the U.S. Department of Defense's TRICARE program.
Humana Military won a five-year, $2 billion contract in 2003 to serve as
the managed-care support contractor for about 2.8 million beneficiaries
in Tennessee, South Carolina, Georgia, Alabama, Mississippi, Florida,
Arkansas, Louisiana, Oklahoma and Texas.
According to Poteet, Humana Veterans operates as an autonomous unit but
works closely with officials at Humana Military and Humana's commercial
insurance units to put together programs with the VA.
"We are looking to do anything we can do with the VA with health care,"
Poteet said. Humana Veterans Healthcare Services Inc.
Description: Subsidiary of Humana Inc. formed to develop business
relationships with the U.S. Department of Veterans Affairs Founded: 2007
Top official: Alfonzo Poteet, CEO Employees: Three, including Poteet
Projects bid: Repricing contract to help government save on purchases of
health care supplies and services and a demonstration program called
Project HERO, which is developing public-private partnerships to manage
health benefits for veterans receiving care outside the VA system
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Larry Scott --
