A Home Health Care News headline from 2023 read: The Uptick In Home-Based Primary Care Is A Trend With Staying Power. Three years later, events are prompting a reevaluation of that trend.

The latest developments involve clinic-based providers, not home-based primary care specifically, but it demonstrates trends that reach across care locations.  

Village Medical, VillageMD’s primary care business focused on people ages 65 and over, recently announced that it was divesting 27 clinics.

This week, Humana Inc. (NYSE: HUM) announced a new joint venture agreement with funds and accounts managed by HPS Investment Partners, a part of BlackRock, to manage and operate 150 CenterWell Senior Primary Care clinics. The announcement comes about six months after CenterWell completed its acquisition of MaxHealth, a primary care platform focused on adults and senior patients in Florida.

Taken together, these events suggest that primary care focused on older adults is experiencing a shakeout. It doesn’t mean that investors and operators are retreating from the model, but it signals a shift in the operating landscape away from the expansion story that seemed clear just a few years ago.

In this week’s exclusive, members-only HHCN+ Update, I analyze the senior-focused primary care industry, offering analysis and key takeaways, including:

— The shift in who delivers older adult-focused primary care

— The shift in how senior primary care expansion is financed

— The implications for home-based care providers and their partnerships

Village Medical’s divestitures

On October 6, Harbor Health announced it had agreed to acquire 27 Texas-based primary care clinics from Village Medical. The deal marks Harbor Health’s second such acquisition — the provider acquired 32 clinics from Village Medical in September 2025.

Harbor Health is a payvider that operates primary and specialty care clinics across Texas. At the time of the 2025 acquisition, Harbor Health co-founder Dr. Clay Johnston said that the deal would help Harbor Health keep up with demand for services, effectively suggesting that the senior-focused primary care model was only growing.

In the most recent announcement of the 27-clinic acquisition, Johnston did not mention demand for services. Of course, this doesn’t mean he doesn’t see demand; the acquisition itself proves Harbor Health sees primary care for older adults as a viable market. But Village Medical’s distancing from senior-focused primary care should be noted.  

The Walgreens-backed national expansion thesis has been unwinding, but buyers still exist for the underlying practices. 

Village Medical’s retreat should be noted, too. While Village Medical is not exclusively a senior-focused provider, its divestitures are relevant to the broader discussion about primary care for older adults — and whether the expansion strategies that attracted so much investment can hold up.

Two things can be true at once: Village Medical’s decision to sell does not necessarily mean that the practices cannot succeed. Harbor Health’s decision to buy does not necessarily mean that the original strategy was sound.

The transaction could, however, suggest that the older adult-focused primary care model is changing, or that, as the model has evolved, the party best suited to deliver it has changed. It could be more viable for a payvider to deliver this type of care because combining insurance and care delivery can allow the organization to capture more of the financial benefit of keeping patients healthy and avoiding expensive care.

The opportunity to deliver primary care to older adults seems viable even as the industry reconsiders which organizations, ownership structures and financing strategies are best suited to pursue it.

Humana’s primary play

Humana’s new joint venture suggests that the insurer is shaking up how it delivers care. The company’s new JV with BlackRock will take over management and operations of nearly 150 CenterWell Senior Primary Care clinics currently held in joint ventures owned by funds affiliated with Welsh, Carson, Anderson & Stowe (WCAS) and CenterWell.  

There are a few details in this deal worth noting. BlackRock will acquire WCAS’s current equity ownership, worth approximately $2.8 billion. Additionally, the JV is expected to deploy additional capital to fund existing operations, establish new clinics, and expand through M&A.  

Then, starting in 2028, CenterWell will have the option to purchase clinics from the JV. If CenterWell has not acquired all of the JV’s clinics by the end of 2033, BlackRock can exit the JV through a sales process for those clinics.  

Per Humana’s press release, the JV is expected to support CenterWell’s growth opportunities, unlock new capital and provide Humana with greater financial flexibility.

“The new joint venture is expected to support future growth opportunities for CenterWell, while also unlocking additional growth capital and providing greater financial flexibility for Humana,” the release read. “BlackRock, one of the world’s leading investment management firms, complements this strategy by delivering substantial capital at scale, along with deep expertise in private financing.”

This news shows that Humana is restructuring its financing to continue growing senior primary care with greater financial flexibility.

Humana may be reshaping CenterWell’s relationship with older adult-focused primary care, but it is not abandoning the concept. CenterWell completed its acquisition of MaxHealth, a primary care organization focusing on adults and older adults, in February. Humana and CenterWell are seeking financial flexibility, not signaling reduced interest.  

The home-based care angle

Taken together, these developments suggest that the primary care industry serving older adults is changing — potentially a sign of maturation and evolution. My bet is that the days of treating rapid clinic proliferation as proof that the model works may be numbered, replaced by more selective growth and closer scrutiny of who owns, operates and finances the care.

That does not necessarily mean fewer clinics or less investment. Harbor Health is expanding, and Humana’s new JV explicitly leaves room for new locations and acquisitions. But growth through buying existing practices or restructuring their financing is different from building a national footprint on the assumption that demand will make the economics work.

For home-based care providers, this means paying attention to the organization behind the primary care relationship. A practice changing hands could create an opening for new referral and care-coordination partnerships. It could also bring different expectations about networks, utilization and how providers demonstrate their value.