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.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
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.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
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.
