Humana Expands Availability of Value-Based Orthopedic Specialty Care to Improve Patient Experience in Seven Additional States
April 12 2018 - 10:00AM
Business Wire
Bundled Payment Model for Humana Medicare
Advantage Members Now Offered in Alabama, Florida, Georgia,
Illinois, Louisiana, Mississippi, and Texas
Leading health and well-being company Humana Inc. (NYSE: HUM) is
expanding the availability of its value-based care bundled payment
model for Humana Medicare Advantage members undergoing total hip or
knee joint replacement procedures, by teaming up with orthopedic
specialty groups in seven additional states. With these agreements,
Humana has more than doubled the number of states in which its
Total Joint Replacement Episode-Based Model is offered,
encompassing more than one-quarter of the nation.
Initially launched in 2016 with orthopedic groups in Ohio and
Tennessee, the model was expanded into Indiana, Kentucky, North
Carolina, and Virginia in 2017. Along with additional agreements in
Indiana, Tennessee, and Virginia, the program will expand to
another seven states - Alabama, Florida, Georgia, Illinois,
Louisiana, Mississippi, and Texas - for a total program footprint
of approximately 40 provider locations in 13 states across
America.
Humana’s newest provider agreements are with Alabama Orthopaedic
Clinic in Alabama; Florida Medical Clinic in Florida; OrthoAtlanta
Orthopedic and Sports Medicine Specialists, Peachtree Orthopedics,
and Resurgens Orthopaedics in Georgia; Illinois Bone & Joint
Institute and OrthoIllinois in Illinois; Ascendant Orthopedic
Alliance in Indiana; Bone & Joint Clinic of Baton Rouge in
Louisiana; Bienville Orthopaedic Specialists and Mississippi Sports
Medicine and Orthopaedic Center in Mississippi; Center for Sports
Medicine & Orthopaedics in Tennessee; TSAOG Orthopaedics in
Texas; and Atlantic Orthopaedic Specialists, OrthoVirginia, and
Riverside Medical Group in Virginia.
“We’re excited to accelerate this innovative value-based care
model into additional markets, significantly growing the reach of a
program specifically tailored for orthopedics,” said Caraline
Coats, Vice President of Humana’s Provider Development Center of
Excellence. “Humana is dedicated to building relationships with
physicians and providing the support they need as we work together
to create a more seamless, patient-centered experience and help
members achieve their best health.”
The orthopedic specialty-care model is designed to improve
quality, outcomes, and cost across a member’s entire joint
replacement episode of care, and it financially incentivizes
orthopedic surgeons for better outcomes. Humana provides
participating orthopedic practices with robust data and analytics
to enhance patient care - from diagnosis to recovery, and the
program is designed to deliver a more coordinated care experience
for the patient, with reductions in readmission and complication
rates.
The orthopedic specialty-care bundled payment program is in
keeping with Humana’s longstanding commitment to value-based care,
which emphasizes:
- More personal time with health
professionals and personalized care that is tailored to each
person’s unique health situation;
- Access to proactive health screenings
and programs that are focused on preventing illness;
- Improved care for people living with
chronic conditions with a focus on avoiding health complications
(watch Humana’s “Better Chronic Management Through Value-Based
Care” video);
- Leveraging technologies, such as data
analytics, that connect physicians and help them work as a team to
coordinate care around the patient; and
- Reimbursement to physicians linked to
the health outcomes of their patients rather than solely on the
quantity of services they provide (fee-for-service).
Humana has an extensive and growing value-based care presence.
As of December 31, 2017, Humana has 1.9 million individual Medicare
Advantage members and approximately 140,000 commercial members who
are cared for by 52,000 primary care physicians in more than 1,000
value-based relationships across 43 states and Puerto Rico. Humana
reached its 2017 calendar year goal of having 66 percent of
Humana’s 2.9 million total individual Medicare Advantage members
seeing primary care physicians in value-based payment
relationships. Humana’s total Medicare Advantage membership is
approximately 3.3 million members, which includes members
affiliated with providers in value-based and standard Medicare
Advantage settings. For more information,
visit humana.com/valuebasedcare.
About Humana
Humana Inc. is committed to helping our millions of medical and
specialty members achieve their best health. Our successful history
in care delivery and health plan administration is helping us
create a new kind of integrated care with the power to improve
health and well-being and lower costs. Our efforts are leading to a
better quality of life for people with Medicare, families,
individuals, military service personnel, and communities at
large.
To accomplish that, we support physicians and other health care
professionals as they work to deliver the right care in the right
place for their patients, our members. Our range of clinical
capabilities, resources and tools – such as in-home care,
behavioral health, pharmacy services, data analytics and wellness
solutions – combine to produce a simplified experience that makes
health care easier to navigate and more effective.
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
Additional Information
Humana is a Medicare Advantage HMO, PPO, and PFFS organization
with a Medicare contract. Enrollment in a Humana plan depends on
contract renewal. The benefit information provided is a brief
summary, not a complete description of benefits. For more
information, contact the plan. Limitations, copayments and
restrictions may apply. Benefits, premium and member cost-share may
change on January 1 of each year. You must continue to pay your
Medicare Part B premium.
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Humana Corporate CommunicationsAlissa Krinsky,
312-441-5576akrinsky@humana.com
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