Closing Care Gaps: Humana, DrFirst Team Up

Humana has partnered with DrFirst, a healthcare technology company specializing in medication management, to launch a program designed to close gaps in care for patients with chronic conditions such as diabetes and cardiovascular disease. The initiative also aims to give providers tools that improve efficiency and patient outcomes.

Through the collaboration, Humana will use DrFirst’s prescription orchestration platform to connect directly with prescribers in their clinical workflow. This will allow the insurer to recommend new prescriptions for high-risk patients and submit them to providers for review. Physicians can then approve the recommendation, generate a new prescription, or indicate why the suggested therapy may not be appropriate. The first phase of the program focuses on expanding statin therapy among eligible patients, aligning with a key quality measure established by the Centers for Medicare and Medicaid Services.

DrFirst’s rules-based system is designed to turn fragmented processes into real-time collaboration by enabling interoperability across providers, pharmacies, and payers. This integrated approach helps reduce information gaps and promotes better patient care. “We’re not just flagging care opportunities, we’re making sure they get to providers in a way that’s timely and easy to act on,” said Bethanie Stein, president of pharmacy at Humana. “By reaching providers in their workflow, we’re freeing them to focus on patient care, which in turn can help address gaps in care, promote quality and lead to better health outcomes.”

DrFirst shares this vision, highlighting that the collaboration is not only about innovative technology but about improving care. “This partnership with Humana is about better patient outcomes,” said Laizer Kornwasser, CEO of DrFirst.

The partnership reflects a larger trend of Humana working closely with digital health companies to expand access and improve outcomes. Over the past year, Humana extended its partnership with Longevity Health through 2030, focusing on quality and member experience in skilled nursing and senior living facilities. It also teamed up with Mercy to open 65 new Prime+ by Mercy Primary Care clinics for Medicare patients, and with Dreem Health to provide members with access to digital sleep technologies. Additionally, Humana partnered with Thyme Care to bring value-based oncology support to Medicare Advantage members in several states.

For DrFirst, this is one of several recent collaborations. In July, the company announced a partnership with Hackensack Meridian Health to integrate AI tools into Epic’s EHR system, giving providers easier access to patient medication histories and insurance information. The company has also attracted significant investment, raising $50 million from Sixth Street Growth in 2021 after a $35 million round the year prior.