Humana Launches Innovative Value-Based Program to Address Social Determinants of Health
March 04 2020 - 10:00AM
Business Wire
Ochsner Health Signs as Inaugural
Participant
Leading health and well-being company Humana Inc. (NYSE: HUM)
today announced the launch of a value-based care payment initiative
designed to support clinicians in addressing nonmedical health risk
factors affecting Humana members. The Social Determinants of Health
Value-Based Program aims to improve health outcomes by encouraging
a more holistic approach to patient care that goes beyond
traditional clinical treatment.
Social determinants are the life circumstances and environments
that impact a person’s health and well-being, including an
increased risk of chronic medical conditions.
Humana’s new program aims to address key factors in particular:
Food insecurity (inconsistent access to nutritious food), social
isolation (lack of interaction with other people), loneliness
(feeling of being alone), and housing instability (lack of stable
housing). The model offers providers tools and resources to
identify and address those social determinants, and will provide
compensation for enhanced care coordination centered on three
program components — patient screenings; documentation of
assessment findings; and connecting the patient to appropriate
resources.
“Humana is committed to advancing the transformation to
value-based care, and incorporating a focus on social determinants
of health is the logical next step in that evolution,” said
Caraline Coats, Vice President of Population Health Strategy at
Humana. “Through this program, Humana is pleased to invest in a new
approach that includes focusing on nonclinical barriers to health.
We’re better able to support clinicians as they broaden the scope
of patient care to improve health outcomes.”
The Social Determinants of Health Value-Based Program is
designed to complement existing value-based agreements between
Humana and health care providers. Its inaugural participant is
Ochsner Health, Louisiana's largest non-profit, academic health
care system.
“We’re pleased to deepen our value-based work with Humana in
identifying and addressing critical drivers of poor health that
occur outside of the doctor’s office,” said Philip Oravetz, MD,
Chief Population Health Officer at Ochsner Health. “This new
program considers the impact of important factors that affect the
well-being of our patients. It’s an exciting development as we
continue to adapt our approach to care to meet the comprehensive
and diverse needs of the communities we serve.”
Humana is dedicated to supporting providers as they move away
from the traditional fee-for-service system. According to Humana’s
most recent annual Value-based Care Report, issued in November,
clinicians in value-based arrangements encouraged more engagement
from their Humana Medicare Advantage members as compared to
providers in non-value based contracts. This has resulted in higher
rates of preventive care and screenings; fewer emergency room
visits and hospital admissions; and higher overall Healthcare
Effectiveness Data and Information Set (HEDIS) scores.
“This new model is part of an ongoing expansion of Humana’s
value-based program portfolio, as we continue to align with
clinicians to more holistically address patients’ health care
needs,” said Oraida Roman, Vice President of Value Based Strategies
at Humana. “Humana is proud to collaborate with providers in
proactively addressing impediments to well-being, instead of only
treating people when they’re sick. We’re committed to addressing
the critical challenges presented by nonmedical health risk
factors.”
Humana has an extensive and growing value-based care presence.
As of Dec. 31, 2019, Humana has more than 2.4 million individual
Medicare Advantage members and approximately 115,000 commercial
members who are cared for by approximately 62,000 primary care
physicians in more than 1,000 value-based relationships across 43
states and Puerto Rico. As of January, 2020, Humana’s total
Medicare Advantage membership is approximately 4.4 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
Other providers are available in our network. The provider may
contract with other Plans.
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Alissa Krinsky Humana Corporate Communications
akrinsky@humana.com
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