Humana Brings Value-Based Orthopaedic Specialty Care Model to Tennessee, Expands in Ohio
May 18 2016 - 12:30PM
Business Wire
Program, based on state Innovation Model
Grants, brings payment bundling to four practices in Tennessee and
two additional in Ohio
Humana Inc. (NYSE: HUM) is partnering with four leading
orthopaedic specialty groups in Tennessee to bring a value-based
bundled payment care model for Humana Medicare Advantage members
undergoing total hip or knee joint replacement procedures. In
addition, Humana is expanding the model in Ohio, which it announced
last month, by adding two more specialty groups in that state.
The care model is designed to improve quality, outcomes and cost
across a person’s entire joint replacement episode of care, and it
financially rewards orthopaedic surgeons for better outcomes.
Humana will also provide the orthopaedic 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
reductions in readmission and complication rates.
The program is based upon the model of care standards developed
for total joint replacement as part of the State of Tennessee’s and
the State of Ohio’s State Innovation Model (SIM) Grant through the
Centers for Medicare and Medicaid Services (CMS). The grants
provide funding and guidance to help transform the health care
system from a fee-for-service model to a value-based system, which
aligns health care provider incentives with quality measures and
rewards better outcomes.
In Tennessee, Humana will be working with Appalachian
Orthopaedic Associates in the Tri-Cities, OrthoTennessee and
Tennessee Orthopaedic Clinics in Knoxville, and Premier
Orthopaedics & Sports Medicine in Nashville.
In addition to the five orthopaedic specialty groups announced
earlier this year in Ohio, Humana will be partnering with Adena
Medical Clinic in Columbus and University of Cincinnati Physicians
in Cincinnati to expand the care model in that state.
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 of
the selected orthopaedic specialists will employ with Humana
members.
Humana Vice President of Payment Innovation Chip Howard says the
purpose is to give orthopaedic surgeons the tools they need to
coordinate all aspects of their patients’ diagnosis, treatment,
recovery and rehabilitation.
“Value-based care is a powerful new approach to more involved
medical procedures like total joint replacement,” said Howard.
“It’s the key to building a health system that focuses on improving
quality, lowering cost and creating a better experience for our
members. We look forward to continue expanding this model.”
Humana has 30 years of experience partnering with primary care
physicians in value-based/accountable care arrangements. In
November 2015, the company released value-based care data
indicating that patients cared for through value-based models
generally experienced healthier outcomes and lower costs. Humana is
now moving to apply the approach to specialties, such as
orthopaedics, where highly coordinated care supported by population
health data has the ability to improve outcomes, lower cost and
deliver a better health care experience for patients.
Humana has 1.7 million individual Medicare Advantage members and
200,000 commercial members today who are cared for by 47,800
primary care providers, in more than 900 value-based relationships
across 43 states and Puerto Rico. For more information, visit
humana.com/accountable-care.
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
- Replays of most recent earnings release
conference calls
- Calendar of events
- Corporate Governance information
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version on businesswire.com: http://www.businesswire.com/news/home/20160518006252/en/
Humana Inc.Marina Renneke, APR, 602-760-1758Corporate
Communicationsmrenneke@humana.com
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