Humana Brings Value-Based Orthopedic Specialty Care to Indiana and Kentucky
April 18 2017 - 11:00AM
Business Wire
Model expected to improve quality, lower cost
of care for Humana Medicare Advantage members
Humana Inc. (NYSE: HUM) is teaming up with eight orthopedic
specialty groups in Indiana and Kentucky on an orthopedic
value-based care model for Humana Medicare Advantage members
undergoing total hip or knee joint replacement procedures.
Humana’s Total Joint Replacement Episode-Based Model is designed
to improve quality, outcomes and cost across a person’s entire
joint replacement episode of care. Humana will provide the
orthopedic practices with robust data and analytics needed to
better manage all aspects of their patients’ care from diagnosis to
recovery. For the patient, this is expected to deliver a more
coordinated care experience and to reduce complication rates and
unnecessary readmissions after surgery.
In Indiana, Humana will work with Fort Wayne Orthopedics, Ortho
NorthEast, Orthopaedic Associates Inc., Tri-State Orthopaedics and
Unity Healthcare LLC.
In Kentucky, Humana will work with Commonwealth Orthopaedic
Centers, Kentucky Bone and Joint Surgeons and Norton Orthopedic
Specialists.
Humana has 30 years of experience partnering with primary care
physicians in value-based arrangements. By focusing on quality and
health, Humana experienced 20 percent lower costs in total in 2015
for members who were treated by doctors and other health care
professionals in a value-based reimbursement model setting versus
an estimation of original fee-for-service Medicare costs using the
Centers for Medicare and Medicaid Services (CMS) Limited Data Set
Files. Humana is now moving to apply the approach to specialties,
such as orthopedics, where highly coordinated care supported by
population health data has the ability to potentially improve
outcomes, lower cost and deliver a better health care experience
for patients.
The participating Indiana and Kentucky orthopedic groups join
the 12 orthopedic groups in Ohio and Tennessee who joined Humana’s
orthopedic value-based care model in 2016.
Humana’s model is similar to the State of Tennessee’s Innovation
Model (SIM) Grant through CMS for Medicaid beneficiaries.
Through the new agreements, Humana’s population health
capabilities, including patient data and analytics as well as
chronic disease management and wellness programs, will complement
the integrated care approach that each orthopedic group will employ
with Humana members.
“Through our total joint replacement model, Humana is taking
value-based care to the next level – from primary care to a more
involved medical procedure,” said Chip Howard, Humana’s Vice
President of Payment Innovation. “Humana’s approach is to provide
orthopaedic surgeons the tools they need to coordinate all aspects
of their patients’ diagnosis, treatment, recovery and
rehabilitation to in turn improve quality, lower cost and create a
better experience for our members.”
As of Dec. 31, 2016, Humana has 1.8 million individual Medicare
Advantage members and 200,000 commercial members today who are
cared for by 50,400 primary care providers, in more than 900
value-based relationships across 43 states and Puerto Rico. For
more information, visit humana.com/accountable-care or
www.humana.com/valuebasedcare.
About Humana
Humana Inc., headquartered in Louisville, Ky., is a leading
health and well-being company focused on making it easy for people
to achieve their best health with clinical excellence through
coordinated care. The company’s strategy integrates care delivery,
the member experience, and clinical and consumer insights to
encourage engagement, behavior change, proactive clinical outreach
and wellness for the millions of people we serve across the
country.
More information regarding Humana is available to investors via
the Investor Relations page of the company’s web site at
www.humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission
filings
- Most recent investor conference
presentations
- Quarterly earnings news releases and
conference calls
- Calendar of events
- Corporate Governance information
More Information
Humana is a Medicare Advantage HMO, PPO and PFFS plan with a
Medicare contract. Enrollment in any Humana plan depends on
contract renewal. This information is not a complete description of
benefits. Contact the plan for more information. Limitations,
copayments and restrictions may apply. Benefits may change each
year. Other providers are available in our network.
Humana Inc. and its subsidiaries (“Humana”) do not discriminate
on the basis of race,color, national origin, age, disability or
sex.
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version on businesswire.com: http://www.businesswire.com/news/home/20170418005360/en/
Humana Inc.Corporate CommunicationsMarina Renneke, APR,
602-760-1758mrenneke@humana.com
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