Humana’s Value-Based Orthopedic Specialty Care Now Available in More Than One-Third of the Nation With Expansion to the Southwest and Northeast

Published: Sep 12, 2018

 
LOUISVILLE, Ky.--(BUSINESS WIRE)-- Leading health and well-being company Humana Inc. (NYSE: HUM) is announcing expanded availability of its value-based care bundled payment model for Humana Medicare Advantage members undergoing total hip or knee joint replacement procedures. Through additional agreements with orthopedic specialty groups across the nation, the Total Joint Replacement Episode-Based Model now is offered in more than one-third of the country – including, for the first time, in the Southwest and Northeast.

Humana’s newest agreements include those with The CORE Institute in Arizona; Coastal Orthopaedics and Sports Medicine in Florida; Physicians’ Clinic of Iowa in Iowa; Baton Rouge Orthopaedic Clinic, Lafayette General Orthopaedic Hospital, LMG, LLC, and Musculoskeletal Institute of Louisiana in Louisiana; Syracuse Orthopedic Specialists in New York; Christ Hospital Orthopedic Associates LLC in Ohio; Texas Orthopedics, Sports & Rehabilitation Associates in Texas; Carilion Clinic in Virginia; and Bellin Health Partners, Inc. and Orthopaedic Associates of Wisconsin in Wisconsin.

The agreements in Arizona, Iowa, Missouri, New York, and Wisconsin are the first in those states, enabling a geographical program expansion; the model is now available at more than 50 medical practices in 18 states across America. Initially launched in 2016 with orthopedic groups in Ohio and Tennessee, the Total Joint Replacement Episode-Based Model was expanded in 2017 into Indiana, Kentucky, North Carolina, and Virginia; and to Alabama, Florida, Georgia, Illinois, Louisiana, Mississippi, and Texas earlier this year.

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 offers the opportunity for additional payment 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 the goal to reduce readmissions and complication rates.

“We’re delighted to collaborate with these orthopedic groups and provide support for them as we work together to drive innovation in health care delivery,” said Brent Stice, Director of Humana’s Value-Based Strategies Organization. “Humana is excited to expand the geographic reach of our voluntary episodic bundling programs, which are a critical part of our continued dedication to value-based care. We’re committed to helping physicians in improving both the quality of care and health outcomes in the communities we serve, and to reducing health care costs.”

The Total Joint Replacement Episode-Based Model is Humana’s inaugural specialty-care bundled payment model. Earlier this year, the company launched a second program, its Maternity Episode-Based Model, for Humana Group members with low-to-moderate-risk pregnancies.

Both bundled payment model programs are 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;
  • 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 based solely on the quantity of services they provide (fee-for-service).

Humana has an extensive and growing value-based care presence. As of June 30, 2018, Humana has approximately two million individual Medicare Advantage members and approximately 130,000 Group members who are cared for by more than 52,000 primary care physicians in more than 1,000 value-based relationships across 43 states and Puerto Rico. Humana’s total Medicare Advantage membership is more than 3.5 million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings. For more information, visit humana.com/provider/support/vbc.

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 and PPO organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.

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Contacts

Humana Corporate Communications
Alissa Krinsky, 312-441-5576
akrinsky@humana.com

 

 
 

Source: Humana Inc.

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