As part of its business shift into value-based care, Louisville, Kentucky-based insurer Humana has announced the inaugural provider partners for its national hospital incentive program.
The four initial participants in the program are the Cleveland Clinic Florida, the Jackson Health System in Florida, Ohio’s TriHealth health system and Marietta, Georgia-based WellStar Health System.
The initiative – focused on general acute care hospitals – was launched earlier this year to provider higher quality, and better integrated care for Humana members through tying provider compensation to performance in the key areas of patient experience, patient safety and patient outcomes.
Some of its major goals include reducing duplication services, hospital readmission rates and complication rates in acute care.
Humana’s incentive program incorporates the integrated care and hospital-based palliative care coordination certifications developed by The Joint Commission.
Humana cares for more than 2 million Medicare Advantage and roughly 115,000 commercial members through around 1,000 value-based relationships which include deals with organizations like Heritage Provider Network, University of Chicago Medicine and Iora Health.
Some of the payer’s overarching goals in its value-based care initiatives are improving care for chronic disease patients, increasing the use of data analytics and technology in care coordination and investing more in proactive health screenings and other preventive care measures.
The health plan has succeeded in shifting the majority of its Medicare Advantage patient population into value-based care programs. Medicare Advantage provides more flexibility in innovation around care coordination and treatment design lowering the barrier of entry to value-based care.
In the study, payers estimated that the fee-for-service payments will continue to decline to around 25.4 percent by 2021, reflecting the larger industry shift to outcomes-based payment models.
Picture: Getty Images, Hong Li
